Safety of Endoscopy in Peritoneal Dialysis Patients

• Published in: Clinical and translational gastroenterology 2021-07, Vol.12 (7), p.e00379-e00379
• Main Authors: Kim, Joon Sung, Jung, Eunha, Kang, Sun Hyung, Ji, Jeong-Seon, Cho, Yu Kyung, Lee, Bo-In, Cho, Young-Seok, Kim, Byung-Wook, Choi, Hwang, Jeong, Hyun Yong, Choi, Myung-Gyu, Park, Jae Myung
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Aged; Aged, 80 and over; Antibiotic Prophylaxis; Antibiotics; Blood; Clinical outcomes; Colonoscopy; Creatinine; Disease prevention; Endoscopy; Endoscopy, Gastrointestinal - adverse effects; Female; Hemodialysis; Humans; Kidney Failure, Chronic - therapy; Leukocytes; Male; Mann-Whitney U test; Middle Aged; Mortality; Ostomy; Pain; Patients; Peritoneal Dialysis; Peritonitis; Peritonitis - etiology; Peritonitis - microbiology; Peritonitis - prevention & control; Potassium; Retrospective Studies; Risk Factors; Statistical analysis; Young Adult
• ISSN: 2155-384X; 2155-384X
• DOI: 10.14309/ctg.0000000000000379

Endoscopic procedures can provoke peritonitis in patients receiving peritoneal dialysis (PD). The aim of this study was to assess the development of peritonitis after endoscopic procedures in PD patients. We retrospectively reviewed the data from PD patients who underwent endoscopies in 3 tertiary hospitals between 2008 and 2018. The patients were grouped into nonprophylactic, prophylactic, and prior antibiotic therapy groups. The incidence of peritonitis within 7 days of endoscopy was assessed. We also examined the factors associated with peritonitis. There were 1,316 endoscopies performed in 570 PD patients. The peritonitis rate after endoscopy was 3.0%. Specifically, the peritonitis rate was 1.8% for esophagogastroduodenoscopies, 4.2% for the colonoscopy group, and 5.3% for the sigmoidoscopy group. The prior antibiotic therapy group showed a significantly higher risk of peritonitis (odds ratio = 4.6; 95% confidence interval: 2.2-9.6; P < 0.01). Prophylactic antibiotics were not associated with reducing peritonitis. Therapeutic colonoscopies such as polypectomy were associated with an increased risk of developing peritonitis (odds ratio = 6.5; 95% confidence interval: 1.6-25.9). However, biopsies were not associated with an increased risk of peritonitis. Prophylactic antibiotics did not reduce the risk of peritonitis after endoscopy in PD patients. Therapeutic colonoscopies such as polypectomy and prior antibiotic therapy before endoscopy were associated with an increased risk of peritonitis.