The Incidence of Peritoneal Dialysis-Related Infection in Thailand: A Nationwide Survey
Talerngsak Kanjanabuch MD*,**,***, Wiwat Chancharoenthana MD*, Pisut Katavetin MD*, Suchai Sritippayawan MD**, Kearkiat Praditpornsilpa MD*, Surapol Ariyapitipan MD****, Somchai Eiam-Ong MD*,**, Prateep Dhanakijcharoen MD****, Dusit Lumlertgul MD**
Affiliation : * Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ** The Nephrology Society of Thailand, Bangkok, Thailand *** Kidney & Metabolic Research Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand **** National Health Security Office of Thailand, Nonthaburi, Thailand
Objective : Implementation of the “Peritoneal Dialysis-First (PD First)” policy, mandating PD as the first modality of renal
replacement therapy for end-stage renal disease patients under universal health coverage, leads to a rapid growth of PD
cases and centers in Thailand. Since PD-related infection is the Achilles’ heel of PD, this retrospective study was conducted
to examine the magnitude of PD-related infection in Thailand under the “PD First” policy.
Material and Method: All PD centers in Thailand were included in the present study. PD nurse specialists in each center were
requested to review medical records of all patients undergoing PD during October 1, 2009 to September 30, 2010 and to
submit data to the main investigators.
Results : Eighty-eight percent of all active PD-centers in Thailand (102 out of 116) participated in the present study. One
hundred and thirty-three nephrologists and 220 PD nurse specialists served 8,201 PD prevalent patients in these centers
(7,925 CAPD and 276 APD). The overall exit-site infection (ESI) rate was 1 episode/ 37.7 patient-month (0.32 episodes/
patient-year) while the overall peritonitis rate was 1 episode/ 25.5 patient-month (0.47 episode/patient-year).
Conclusion : Despite the rapid growth of PD cases under the limited resource, the PD-related infection rates in Thailand are
only small degree behind the goal of Asia-Pacific Key Performance Indicators (KPIs) Task Force.
Keywords : Peritoneal dialysis-related infection, Peritonitis rates, Exit-site infection rate, PD First policy
