Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Pediatric Nephrology
Published in: Pediatric Nephrology 12/2023

05-07-2023 | Peritoneal Dialysis | Original Article

Pediatric peritoneal dialysis training program and its relationship to peritonitis: a study of the International Pediatric Peritoneal Dialysis Network

Authors: Nivedita Kamath, Dagmara Borzych-Dużałka, Amrit Kaur, Gisela Neto, Klaus Arbeiter, Yok Chin Yap, Annie Lahoche, Loai Eid, Nakysa Hooman, Troy Richardson, Franz Schaefer, Bradley A. Warady, on behalf of the IPPN participants

Published in: Pediatric Nephrology | Issue 12/2023

Login to get access

Abstract

Background

The guidelines for training of patients and caregivers to perform home peritoneal dialysis (PD) uniformly include recommendations pertaining to the prevention of peritonitis. The objective of this study conducted by the International Pediatric Peritoneal Dialysis Network (IPPN) was to investigate the training practices for pediatric PD and to evaluate the impact of these practices on the peritonitis and exit-site infection (ESI) rate.

Methods

A questionnaire regarding details of the PD program and training practices was distributed to IPPN member centers, while peritonitis and ESI rates were either derived from the IPPN registry or obtained directly from the centers. Poisson univariate and multivariate regression was used to determine the training-related peritonitis and ESI risk factors.

Results

Sixty-two of 137 centers responded. Information on peritonitis and ESI rates were available from fifty centers. Training was conducted by a PD nurse in 93.5% of centers, most commonly (50%) as an in-hospital program. The median total training time was 24 hours, with a formal assessment conducted in 88.7% and skills demonstration in 71% of centers. Home visits were performed by 58% of centers. Shorter (< 20 hours) training duration and lower number of training tools (both p < 0.02) were associated with higher peritonitis rate, after adjustment for proportion of treated infants and income of country of residence.

Conclusions

An association between training duration and the number of training tools represent potentially modifiable risk factors to reduce peritonitis rates within the pediatric PD population.

Graphical abstract

Appendix
Available only for authorised users
Literature
1.
2.
Annual Report of the North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS). 2008
3.
Chadha V, Schaefer FS, Warady BA (2010) Dialysis-associated peritonitis in children. Pediatr Nephrol 25:425–440CrossRefPubMed
4.
Redpath Mahon A, Neu AM (2017) A contemporary approach to the prevention of peritoneal dialysis-related peritonitis in children: the role of improvement science. Pediatr Nephrol 32:1331–1341CrossRefPubMed
5.
Neu AM, Richardson T, Lawlor J, Stuart J, Newland J, McAfee N, Warady BA, SCOPE Collaborative Participants (2016) Implementation of standardized follow-up care significantly reduces peritonitis in children on chronic peritoneal dialysis. Kidney Int 89:1346–1354CrossRefPubMed
6.
Li PK, Szeto CC, Piraino B, de Arteaga J, Fan S, Figueiredo AE, Fish DN, Goffin E, Kim YL, Salzer W, Struijk DG, Teitelbaum I, Johnson DW (2016) ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment. Perit Dial Int 36:481–508CrossRefPubMedPubMedCentral
7.
Redpath Mahon AC, Richardson T, Neu AM, Warady BA (2019) Factors associated with high-cost hospitalization for peritonitis in children receiving chronic peritoneal dialysis in the United States. Pediatr Nephrol 34:1049–1055CrossRefPubMed
8.
Schaefer F, Feneberg R, Aksu N, Donmez O, Sadikoglu B, Alexander SR, Mir S, Ha IS, Fischbach M, Simkova E, Watson AR, Möller K, von Baum H, Warady BA (2007) Worldwide variation of dialysis-associated peritonitis in children. Kidney Int 72:1374–1379CrossRefPubMed
9.
Bernardini J, Price V, Figueiredo A (2006) Peritoneal dialysis patient training, 2006. Perit Dial Int 26:625–632CrossRefPubMed
10.
11.
Figueiredo AE, Bernardini J, Bowes E, Hiramatsu M, Price V, Su C, Walker R, Brunier G (2016) A syllabus for teaching peritoneal dialysis to patients and caregivers. Perit Dial Int 36:592–605CrossRefPubMedPubMedCentral
12.
Li PK, Chow KM, Cho Y, Fan S, Figueiredo AE, Harris T, Kanjanabuch T, Kim YL, Madero M, Malyszko J, Mehrotra R, Okpechi IG, Perl J, Piraino B, Runnegar N, Teitelbaum I, Wong JK, Yu X, Johnson DW (2022) ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment. Perit Dial Int 42:110–153CrossRefPubMed
13.
Warady BA, Bakkaloglu S, Newland J, Cantwell M, Verrina E, Neu A, Chadha V, Yap HK, Schaefer F (2012) Consensus guidelines for the prevention and treatment of catheter-related infections and peritonitis in pediatric patients receiving peritoneal dialysis: 2012 update. Perit Dial Int 32:32–86CrossRef
14.
Schaepe C, Bergjan M (2015) Educational interventions in peritoneal dialysis: A narrative review of the literature. Int J Nurs Stud 52:882–898CrossRefPubMed
15.
Cheetham MS, Zhao J, McCullough K, Fuller DS, Cho Y, Krishnasamy R, Boudville N, Figueiredo AE, Ito Y, Kanjanabuch T, Perl J, Piraino BM, Pisoni RL, Szeto CC, Teitelbaum I, Woodrow G, Johnson DW (2022) International peritoneal dialysis training practices and the risk of peritonitis. Nephrol Dial Transplant 37:937–949CrossRefPubMed
16.
Chen TW, Li SY, Chen JY, Yang WC (2008) Training of peritoneal dialysis patients—Taiwan’s experiences. Perit Dial Int 28:72–75CrossRef
17.
Chow JS, Adams K, Cho Y, Choi P, Equinox KL, Figueiredo AE, Hawley CM, Howard K, Johnson DW, Jose MD, Lee A, Longergan M, Manera KE, Moodie JA, Paul-Brent PA, Pascoe EM, Reidlinger D, Steiner GZ, Tomlins M, Tong A, Voss D, Boudville NC (2020) Targeted education ApproaCH to improve peritoneal dialysis outcomes (TEACH-PD): A feasibility study. Perit Dial Int 40:153–163CrossRef
18.
Kazancioglu R, Ozturk S, Ekiz S, Yucel L, Dogan S (2008) Can using a questionnaire for assessment of home visits to peritoneal dialysis patients make a difference to the treatment outcome? J Ren Care 34:59–63CrossRefPubMed
19.
Bordin G, Casati M, Sicolo N, Zuccherato N, Eduati V (2007) Patient education in peritoneal dialysis: an observational study in Italy. J Ren Care 33:165–171CrossRefPubMed
20.
Russo R, Manili L, Tiraboschi G, Amar K, De Luca M, Alberghini E, Ghiringhelli P, De Vecchi A, Porri MT, Marinangeli G, Rocca R, Paris V, Ballerini L (2006) Patient re-training in peritoneal dialysis: why and when it is needed. Kidney Int Suppl 103:127–132CrossRef
21.
Ozturk S, Yucel L, Guvenc S, Ekiz S, Kazancioglu R (2009) Assessing and training patients on peritoneal dialysis in their own homes can influence better practice. J Ren Care 35:141–146CrossRefPubMed
22.
Bender FH, Bernardini J, Piraino B (2006) Prevention of infectious complications in peritoneal dialysis: best demonstrated practices. Kidney Int 70:44–54CrossRef
23.
24.
Holloway M, Mujais S, Kandert M, Warady BA (2001) Pediatric peritoneal dialysis training: characteristics and impact on peritonitis rates. Perit Dial Int 21:401–404CrossRefPubMed
25.
Gadola L, Poggi C, Poggio M, Sáez L, Ferrari A, Romero J, Fumero S, Ghelfi G, Chifflet L, Borges PL (2013) Using a multidisciplinary training program to reduce peritonitis in peritoneal dialysis patients. Perit Dial Int 33:38–45CrossRefPubMedPubMedCentral
26.
Hall G, Bogan A, Dreis S, Duffy A, Greene S, Kelley K, Lizak H, Nabut J, Schinker V, Schwartz N (2004) New directions in peritoneal dialysis patient training. Nephrol Nurs J 31(149–54):159–163
27.
Zgoura P, Hettich D, Natzel J, Özcan F, Kantzow B (2019) Virtual reality simulation in peritoneal dialysis training: the beginning of a new era. Blood Purif 47:265–269CrossRefPubMed
28.
Zhang L, Hawley CM, Johnson DW (2016) Focus on peritoneal dialysis training: working to decrease peritonitis rates. Nephrol Dial Transplant 31:214–222PubMed
29.
Zaritsky JJ, Hanevold C, Quigley R, Richardson T, Wong C, Ehrlich J, Lawlor J, Rodean J, Neu A, Warady BA, SCOPE Investigators (2018) Epidemiology of peritonitis following maintenance peritoneal dialysis catheter placement during infancy: a report of the SCOPE collaborative. Pediatr Nephrol 33:713–722CrossRefPubMed
30.
Schaefer F, Borzych-Duzalka D, Azocar M, Munarriz RL, Sever L, Aksu N, Barbosa LS, Galan YS, Xu H, Coccia PA, Szabo A, Wong W, Salim R, Vidal E, Pottoore S, Warady BA, IPPN investigators (2012) Impact of global economic disparities on practices and outcomes of chronic peritoneal dialysis in children: Insights from the international pediatric peritoneal dialysis network registry. Perit Dial Int 32:399–409CrossRefPubMedPubMedCentral
Metadata
Title
Pediatric peritoneal dialysis training program and its relationship to peritonitis: a study of the International Pediatric Peritoneal Dialysis Network
Authors
Nivedita Kamath
Dagmara Borzych-Dużałka
Amrit Kaur
Gisela Neto
Klaus Arbeiter
Yok Chin Yap
Annie Lahoche
Loai Eid
Nakysa Hooman
Troy Richardson
Franz Schaefer
Bradley A. Warady
on behalf of the IPPN participants
Publication date
05-07-2023
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 12/2023
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-023-05995-x

Other articles of this Issue 12/2023

Pediatric Nephrology 12/2023 Go to the issue

Original Article

Association between lifestyle modifications and improvement of early cardiac damage in children and adolescents with excess weight and/or high blood pressure

Educational Review

The first randomized controlled trial in pediatric nephrology: the history of the International Study of Kidney Disease in Children (ISKDC)

Original Article

Angiotensin II type 1 receptor antibodies and native kidney function in pediatric liver and intestinal transplant recipients

Original Article

A novel risk score for predicting prolonged length of stay following pediatric kidney transplant

Educational Review

Tidal continuous cycling peritoneal dialysis in children

Review

Sodium handling in pediatric patients on maintenance dialysis