Abstract

Background

Exit-site infection (ESI) is a common recurring complication in patients undergoing peritoneal dialysis (PD). Sucrose and povidone–iodine (SPI) mixtures, antimicrobial ointments that promote wound healing, have been used for the treatment of ulcers and burns, but their efficacy in exit–site care is still unclear.

Methods

This single-center retrospective observational study included patients who underwent PD between May 2010 and June 2022 and presented with episodes of ESI. Patients were divided into SPI and non-SPI groups and followed up from initial ESI onset until PD cessation, death, transfer to another facility, or June 2023.

Results

Among the 82 patients (mean age 62, [54–72] years), 23 were treated with SPI. The median follow-up duration was 39 months (range, 14–64), with an overall ESI incidence of 0.70 episodes per patient-year. Additionally, 43.1% of second and 25.6% of third ESI were caused by the same pathogen as the first. The log-rank test demonstrated significantly better second and third ESI-free survival in the SPI group than that in the non-SPI group (p < 0.01 and p < 0.01, respectively). In a Cox regression analysis, adjusting for potential confounders, SPI use was a significant predictor of decreased second and third ESI episodes (hazard ratio [HR], 0.22; 95% confidence interval [CI], 0.10–0.52 and HR, 0.22; 95%CI, 0.07–0.73, respectively).

Conclusions

Our results showed that the use of SPI may be a promising option for preventing the incidence of ESI in patients with PD.

Trial registration

This study was approved by the Keio University School of Medicine Ethics Committee (approval number 20231078) on August 28, 2023. Retrospectively registered.

Details

Title
Efficacy of sucrose and povidone–iodine mixtures in peritoneal dialysis catheter exit-site care
Author
Nakayama, Takashin; Morimoto, Kohkichi; Uchiyama, Kiyotaka; Washida, Naoki; Kusahana, Ei; Eriko Yoshida Hama; Mitsuno, Ryunosuke; Tonomura, Shun; Yoshimoto, Norifumi; Hishikawa, Akihito; Hagiwara, Aika; Azegami, Tatsuhiko; Yoshino, Jun; Monkawa, Toshiaki; Yoshida, Tadashi; Yamaguchi, Shintaro
Pages
1-10
Section
Research
Publication year
2024
Publication date
2024
Publisher
BioMed Central
e-ISSN
14712369
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3054177931
Copyright
© 2024. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.