Training practices and peritonitis rates in children on maintenance peritoneal dialysis: results from the Standardizing Care to Improve Outcomes in Pediatric End Stage Kidney Disease (SCOPE) collaborative.
Document Type
Article
Publication Date
10-2023
Identifier
DOI: 10.1007/s00467-023-05975-1
Abstract
BACKGROUND: Comprehensive training of children on peritoneal dialysis (PD) and their caregivers is crucial to minimize peritonitis risk. Few studies have evaluated the impact of training on infection, so many published recommendations rely on expert opinion. This study uses data from the SCOPE collaborative to examine the impact of compliance with 4 components of PD training on the risk for peritonitis.
METHODS: A retrospective cohort study of children enrolled in the SCOPE collaborative between 2011 and 2021 who received training prior to initiating PD. Compliance with 4 training components were assessed: performance of a home visit, 1:1 training, delaying training ≥ 10 days after PD catheter insertion and average individual training session length ≤ 3 h. Univariate and multivariable generalized linear mixed modeling were used to assess relationships between peritonitis ≤ 90 days after PD training and median days to peritonitis and compliance with each component as well as all-or-none compliance.
RESULTS: Among 1450 trainings, 51.7% had median session length ≤ 3 h, 67.1% delayed training ≥ 10 days after catheter insertion, 74.3% had a home visit and 94.6% had 1:1 training. Only 333 trainings (23%) were compliant with all 4 training components. There was no statistically significant association between compliance with individual components, or all-or-none compliance and either the percentage of catheters with peritonitis ≤ 90 days after training end or median days to peritonitis.
CONCLUSION: No associations between 4 PD training components and risk for peritonitis were found. SCOPE requires monthly review of PD catheter practices which may have decreased the impact of training non-compliance. A higher resolution version of the Graphical abstract is available as Supplementary information.
Journal Title
Pediatric nephrology (Berlin, Germany)
Volume
38
Issue
10
First Page
3401
Last Page
3406
MeSH Keywords
Humans; Child; Retrospective Studies; Catheters, Indwelling; Peritoneal Dialysis; Kidney Failure, Chronic; Peritonitis
Keywords
Children; Peritoneal dialysis; Peritonitis; Training
Recommended Citation
Begin B, Richardson T, Ehrlich J, Warady BA, Neu AM; Standardizing Care to Improve Outcomes in Pediatric End Stage Kidney Disease (SCOPE) collaborative participating centers. Training practices and peritonitis rates in children on maintenance peritoneal dialysis: results from the Standardizing Care to Improve Outcomes in Pediatric End Stage Kidney Disease (SCOPE) collaborative. Pediatr Nephrol. 2023;38(10):3401-3406. doi:10.1007/s00467-023-05975-1
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