Hospitalization in Peritoneal Dialysis Patients

Kang, Seong Sik; Hwang, Eun Ah; Jang, Mi Hyun; Choi, Go; Yeo, Sang Mok; Han, Seung Yeup; Park, Sung Bae; Kim, Hyun Chul

Abstract

PURPOSE
Hospitalization as a measure of morbidity in peritoneal dialysis (PD) patients is mainly related to peritonitis. And the hospitalization rate is expected to decrease as the peritonitis rate has decreased substantially with development of connectology. Yet there is no internal study on hospitalization. We evaluated hospitalization rates, causes and duration of admission of PD patients, and their prognosis.
METHODS
We retrospectively reviewed the medical records of 414 patients who started and followed up at least three months at the Keimyung University Dongsan Hospital from January 2003 to December 2008.
RESULTS
There were 1,036 admissions in 328 patients during a mean follow-up of 29.9 months. The admission rate was 1.0 per patients-year and hospital days were 17.1 per patients-year. The number of patients admitted once was 102 (31.1%), and more than 5 was 71 (21.7%). The most common cause of hospital admission was peritonitis (36.5%), followed by volume imbalance (13.8%), gastrointestinal disease (6.9%), other infection (6.2%), neurologic disease (5.5%), surgery (5.4%) and cardiac disease (4.3%). Catheter-related problems, including catheter related infection (1.8%) and catheter dysfunction (1.4%) were uncommon. Duration of admission was longest in neurologic disease (18.0+/-19.0) and shortest in catheter-related problems (9.3+/-3). Duration of admission of peritonitis (16.1+/-8.0) was similar to mean duration. Hospitalization was significantly greater in patients with prior history of peritonitis (p<0.000), and longer duration on PD (p<0.000). There were no significant differences in one and five year patient and catheter survival between hospitalized and non-hospitalized PD patients.
CONCLUSION
Peritonitis remains a major cause of hospitalization in PD patients. To decrease admissions of PD patients, patient education and attention needs to be focused on preventing peritonitis. Also we should pay more attention to prevent multiple admissions due to recurrent peritonitis.