What question did this study set out to answer?

The study aims to evaluate the management practices surrounding exit-site care and their impact on peritonitis and infection rates in peritoneal dialysis patients.

March 28, 2026Open Access

WCN26-3773 Survey of exit-site management practices of peritoneal dialysis in Japan

Key Points

The study aims to evaluate the management practices surrounding exit-site care and their impact on peritonitis and infection rates in peritoneal dialysis patients.
Retrospective analysis of 113 peritoneal dialysis patients from January 2023 to March 2025.
Stratification into self-care PD, family-assisted PD, and helper-assisted PD.
Primary outcome measured was the occurrence of peritonitis; secondary outcomes included exit-site infection and hospitalisation rates.
Statistical analyses employed included Kaplan-Meier survival estimates and Cox regression for adjustments.
Patients on helper-assisted PD had a higher incidence of peritonitis and longer hospitalisation.
Mean age of helper-assisted PD patients was significantly higher compared to others.
Diabetes was the most common cause of end-stage kidney failure in this group.
No significant differences in mortality observed, but unadjusted technique failure rates appeared worse for helper-assisted PD.

Abstract

Methods:We retrospectively analysed 113 incident PD patients (January 2023-March 2025) at a Singapore regional hospital, stratified into self-care PD (scPD), family-assisted PD, and helper-assisted PD.The primary outcome was the first peritonitis, expressed as episodes per patient-day at risk.Secondary outcomes included exit-site infection (ESI), hospitalisation, readmission, mortality, and technique failure (death, membrane failure, refractory infection, social reasons, pleuroperitoneal fistula).Kaplan-Meier (KM) survival with log-rank testing and Cox regression (adjusted for age, Charlson Comorbidity Index CCI, and functional score) were applied.Results: Of 113 patients (mean age 60.3 12.6 years; 57% male; 46% Chinese, 31% Malay, 9% Indian), 52 were on scPD, 42 family-assisted, and 17 helper-assisted PD. asPD patients were older (65.4 vs 54.2 years, p<0.001) and more often female (56% vs 33%, p=0.028).Diabetes accounted for 78% of ESKF. Conclusion:In this first Singapore multiethnic cohort, asPD-whether by family or domestic helpers-was associated with higher peritonitis incidence and longer hospitalisation.Mortality was not significantly different, while technique failure appeared worse on unadjusted analysis but lost significance after adjustment.These findings highlight the need for structured support and targeted training for helpers to optimise outcomes in high-risk asPD patients.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.

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