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논문분류	춘계학술대회 초록집
제목	ISPD Peritonitis Guideline: 2022 Update
저자	Philip Li
출판정보	2022; 2022(1):
키워드
초록	Around the world there is a trend to see PD prevalence is on the rise in both developing and developed world. So such a general growth for PD also calls for bigger need for education, training and standards that would push the quality of PD care to a higher level. At the same time that PD and HD have comparable outcomes and patient survival, there are clinical challenges of peritoneal dialysis. These include: peritoneal infections, malnutrition & inflammation, cardiovascular mortality, volume overload, glucose exposure, peritoneal access, adequacy of solute removal, peritoneal physiology and changes with long term PD and patient fatigue. Peritoneal dialysis (PD)-associated peritonitis is a serious complication of PD and prevention and treatment of such is important in reducing patient morbidity and mortality. The ISPD 2022 updated recommendations have revised and clarified definitions for refractory peritonitis, relapsing peritonitis, peritonitis-associated catheter removal, PD-associated haemodialysis transfer, peritonitis-associated death and peritonitis-associated hospitalisation. New peritonitis categories and outcomes including pre-PD peritonitis, enteric peritonitis, catheter-related peritonitis and medical cure are defined. The new targets recommended for overall peritonitis rate should be no more than 0.40 episodes per year at risk and the percentage of patients free of peritonitis per unit time should be targeted at >80% per year. Revised recommendations regarding management of contamination of PD systems, antibiotic prophylaxis for invasive procedures and PD training and reassessment are included. New recommendations regarding management of modifiable peritonitis risk factors like domestic pets, hypokalaemia and histamine-2 receptor antagonists are highlighted. Updated recommendations regarding empirical antibiotic selection and dosage of antibiotics and also treatment of peritonitis due to specific microorganisms are made with new recommendation regarding adjunctive oral N-acetylcysteine therapy for mitigating aminoglycoside ototoxicity. Areas for future research in prevention and treatment of PD-related peritonitis are suggested. Li PK, et al. ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment. Perit Dial Int 2022 Mar;42(2):110-153 Li PKT, et al. ISPD peritonitis recommendations: 2016 update on prevention and treatment. Perit Dial Int 2016; 36(5): 481-508 LI PKT, et al. Current Challenges and Opportunities in PD. Seminars in Nephrology 2017 Jan;37(1):2-9 Li PKT, et al. Changes in the worldwide epidemiology of peritoneal dialysis. Nature Reviews Nephrology 2017 Feb;13(2):90-103 LI PKT, et al. Inflammation and Peritoneal Dialysis. Seminars in Nephrology 2017 Jan;37(1):54-65 Li PK, et al. Tackling Dialysis Burden around the World: A Global Challenge. Kidney Dis (Basel) 2021 May;7(3):167-175.
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