Risk of peritonitis after gastroscopy in peritoneal dialysis patients. Issue 2 (March 2022)

• Record Type: Journal Article
• Authors: Chan, Gordon Chun-Kau; Wong, Sunny Hei; Ng, Jack Kit-Chung; Li, Philip Kam-Tao; Szeto, Cheuk-Chun; Chow, Kai-Ming
• Is Part Of: Peritoneal dialysis international. Volume 42:Issue 2(2022)
• Page Start: 162
• Page End: 170
• Publication Date: 2022-03
• Subjects: Antibiotics -- endoscopy -- gastroscopy -- peritonitis; Peritoneal dialysis -- Periodicals; Continuous ambulatory peritoneal dialysis -- Periodicals; 617.461059
• DOI: 10.1177/08968608211018608
• Languages: English
• ISSNs: 0896-8608

Abstract

Background: Peritonitis is a common and serious complication of peritoneal dialysis (PD). Translocation of gut bacteria to peritoneum is an important mechanism, which may be enhanced by gastrointestinal endoscopy. Methods: In this retrospective observational cohort study, we identified 450 gastroscopies performed in PD patients within a single centre between 2014 and 2019. Gastroscopy-related peritonitis was defined by peritonitis within 1 week after endoscopy. Results: A total of 408 endoscopic episodes in 216 patients were analysed after excluding 42 cases with either pre-existing peritonitis before endoscopy, or concomitant biliary, small bowel or large bowel endoscopy. There were 16 episodes of peritonitis within 1 week of endoscopy (3.9%). One-quarter of cases were polymicrobial (four episodes, 25.0%). Logistic regression model showed that patient's age, number of endoscopic biopsies, and histamine-2 receptor blocker use were independently associated with peritonitis, while prior antibiotics exposure was associated with lower risk of peritonitis, odds ratio 0.23 (95% confidence interval 0.06–0.95; p = 0.04). Conclusion: Peritonitis can complicate gastroscopy in PD patients and occurs more often in elderly or after repeated biopsy procedures.