The comparison of exit-site care with normal saline and providence- iodine in preventing exit-site infection and peritonitis in children on chronic peritoneal dialysis treatment

Abstract EN

Peritonitis and catheter exit-site infections (ESI) are important causes of hospitalization and catheter loss in patients undergoing chronic peritoneal dialysis (CPD).

The frequency of infection can be reduced by scrupulous exit-site care with or without topical antiseptics.

There are no studies showing any benefit in the use of providence-iodine or normal saline for care of exit-sites in long-term CPD patients.

In this study, we aimed to determine the potential effectiveness of the application of providence-iodine or normal saline at the catheter exit-site in preventing ESI and peritonitis in children on CPD.

A total of 98 patients treated with either providence-iodine or normal saline were included in this study.

Group I (34 patients) used providence-iodine and group II (64 patients) simply cleansed the exit-site with normal saline (0.9% NaCl).

Dressings were changed 2 to 3 times in a week.

The total cumulative follow-up time was 3233 patient-months.

ESIs occurred in 10 (29.4%) of 34 patients using providence-iodine and in 10 (15.6%) of 64 patients using normal saline.

The frequency of ESI was significantly high in group I (providence-iodine) patients.

The mean rate of ESI was 1 episode/60.8 patient-months for group I versus 1 episode / 144 patient-months for group II (P < 0.05).

The rate of peritonitis was similar in each group (1 episode/21.3 pa-tient-months for group I versus 1 episode / 20.17 patient-months for group II) (P > 0.05).

In con-collusion, exit-site care with normal saline is an effective strategy in reducing the incidence of ESI in children on CPD.

It can thus significantly reduce morbidity, catheter loss, and the need to transfer patients on peritoneal dialysis to hemodialysis.