Abstract: Objectives For better prevention and treatment of peritonitis in patients with continuous ambulatory peritoneal dialysis (CAPD), we investigated the pathogens, inducing factors, clinical features and prognosis of the first episode of peritonitis in these patients. Methods A total of 67 patients experienced the first episode of peritonitis from Aug. 2002 to Oct. 2013 were recruited and divided into 2 groups based on clinical outcomes. Forty-one patients cured and 26 patients were treated with extubation. All patients were empirically treated with antibiotics after diagnosis. Antibiotic regimen was then adjusted according to the results of
culture and drug sensitivity tests. Demographic data, primary kidney disease, dialysis age, inducing factors, clinical indexes, bacterial culture results, therapies and clinical outcomes were collected for analyses. Results Patients with peritonitis were older than the controls (53.1±14.9 yr vs. 46.6±14.3 yr). Hypoproteinemia aggravated after the onset of peritonitis (ALB: 27.4±4.0 g/L vs. 32.5±5.7 g/L) . A higher incidence of inappropriate operation (53.7%) was found in patients with peritonitis. Extubation patients had longer dialysis age [24(11.4, 42) months vs. 13.2 (4.8, 18.84) months, P=0.020] and more severe hypoproteinemia (24.5±5.8 g/L vs. 29.3± 4.1 g/L, P=0.000) than the cured patients. In most extubation patients, the extubation was unrelated to mis-operation (61%vs. 36%, P=0.01) and the pathogens were non-Gram+ bacteria (74%vs. 41%, P＜0.001) as compared with the cured patients. Conclusions The first episode of peritonitis is related to older age, malnutrition, and inappropriate operation. Patients with longer dialysis age, severe hypoproteinemia, non-Gram+bacterial infection, and less mis-operation tend to have a higher risk of extubation.

Key words: Continuous ambulatory peritoneal dialysis, Peritonitis, risk of exbutation, hypoproteinemia, dialysis age