Introducción: Se describe que las características de la vivienda son un factor importante para llevar a cabo adecuadamente el tratamiento de diálisis peritoneal, sin embargo, no se conoce la real relación entre las características de la vivienda y el desarrollo de la peritonitis. Métodos: Se realizó una cohorte retrospectiva que incluyó a todos los pacientes mayores de 18 años de edad que iniciaron el tratamiento de diálisis peritoneal dentro del periodo enero 2002 - diciembre 2011 en el Hospital Nacional Guillermo Almenara Irigoyen. Se describió los tiempos de seguimiento según la fecha de inicio de DP y la primera peritonitis u otros eventos (paso a hemodiálisis, trasplante, muerte o abandono). Las variables fueron evaluadas según su tipo, utilizando estadística descriptiva e inferencial. Resultados: El análisis incluyó a 218 pacientes con una media de edad de 54 años ± 16. El principal lugar donde se realiza el procedimiento de diálisis peritoneal es el dormitorio (77,3%), en su mayoría se encuentra limpio (54,3%), ordenado (71,3%) y despejado (61,8%). Los insumos para el procedimiento se almacenan bajo techo (95,7%) y el mismo paciente ejecuta el tratamiento en la mayoría de los casos (73,1%). La incidencia encontrada fue de 0,17 episodios/paciente-año. La media del tiempo de seguimiento fue de 975 días ± 750. De acuerdo al análisis realizado no se encontró resultados significativos que muestren la relación entre las variables de vivienda y el desarrollo de la primera peritonitis. Conclusión: No se encontró asociación entre las condiciones de vivienda y el desarrollo de peritonitis en pacientes en tratamiento de diálisis peritoneal. Es necesario evaluar y mejorar el programa de visitas domiciliarias / Background: The features of housing are an important risk factor to properly carry out the treatment of peritoneal dialysis. However, the actual situation is that it doesn’t know the real relationship between the characteristics of housing and the development of peritonitis. Methods: A retrospective cohort was made including all patients over 18 years who started PD between the period January 2002 and December 2011 at the Hospital National Guillermo Almenara Irigoyen. The follow-up times was described as the beginning date of use DP and the first peritonitis or other events (hemodialysis, transplant, death or abandonment). The variables were evaluated according to their type using descriptive and inferential statistic. Results: The analysis included 218 patients with a mean age of 54 years ± 16. The main place where the patients did the procedure of peritoneal dialysis is the bedroom (77,3%), most of it is clean (54,3%), organized (71,3%) and clear (61,8%). The inputs for the procedure are stored indoors (95,7%) and the person who executes the procedure is the patient in most cases (73,1%). The observed incidence was 0,17 episodes/patient-year. The mean follow-up time was 975 days ± 750. No significant results were found between the housing conditions and the development of the first peritonitis in patients who are treated by peritoneal dialysis. Conclusion: No association was found between the housing conditions and the development of the first peritonitis. It is necessary to evaluated and improve the home visit program in order to obtain better information of housing condition.

A patient has two possibilities when it comes to the replacement of a function of kidneys a hemodialysis or a peritoneal dialysis. The aim of those dialysis is to remove the waste matter, water and redundant salts, which are maintained in the blood due to the dysfunction of kidneys. This thesis is focused on the evaluation of the quality of life of patients with hemodialysis and peritoneal dialysis. The thesis is divided into two parts -- a theoretical and a practical one. In the first part you can find the characteristics and the main principle of the hemodialysis and peritoneal dialysis and there is also a definition of a term the quality of life. The second part is based on a questionnaire survey dedicated to the personal perception of the quality of life of the patients with hemodialysis and peritoneal dialysis in Jindřichův Hradec and Tábor.

We accessed data on patients undergone peritoneal dialysis (PD), a technique that is underused in most countries and is not usually employed as the initial therapeutic option. The study aimed to characterize the DP program at a reference unit in the Northeast Region of Brazil. It was based on a retrospective cohort study that evaluated the clinical and socio-demographic profile, treatment history and causes of death of 565 incident patients who remained in PD for at least 30 days. Results were obtained: mean age was 54 ± 19 years when they started on PD. Males were 55%, 38% from Aracaju, 62% from Sergipe, 76% had <4 years of schooling and 88% earned <5 minimum wages as family income. Diabetic nephropathy was the main etiology (25%) and 77% were hypertensive. There was 9% of late referencing. The majority started on PD as the first dialytic procedure (53%), and (58%) as an emergency. The patients remained in PD for an average of 710.5 (± 714.2) days. PD was the initial dialysis modality for 302 patients (53%). A total of 676 peritoneal catheters were implanted, mean of 1.19 / patient. The median survival of the PD technique was 83.1 months, with a rate of 85.1% in 2 years and 61.1% in 5 years. The median survival of patients was 32.9 months for patients without DM, with a 2-year survival rate of 52.4% and a 5-year survival rate of 22.3. During the study, 353 individuals (62%) died. The etiology of renal disease was identified in 37% of the cases. The odds ratio (OR) of death of those who were referred late was 2,032 times greater than those who did conservative treatment. In conclusion, despite non favorable social indices, survival, peritonitis and complications rates were similar to those described in the literature. / Este estudo aborda a diálise peritoneal (DP), técnica que se mostra subutilizada na maioria dos países e geralmente não é oferecida como opção terapêutica inicial. Tem como objetivo caracterizar os resultados do programa de DP, avaliar frequência, etiologia e fatores associados à peritonite em pacientes sob DP em um centro de referência na região nordeste do Brasil. Avaliou a partir de um estudo de coorte retrospectivo, o perfil clínico e sociodemográfico, histórico de tratamento e causas de óbito associadas a fatores relacionados a peritonite de 565 pacientes incidentes que permaneceram em DP por pelo menos 30 dias. Foram resultados obtidos: a média de idade foi 54±19 anos quando iniciaram em DP. Sexo masculino foi 55%, sendo 38% procedentes de Aracaju, 62% residentes no interior de Sergipe, 76% com <4 anos de estudo e 88% com renda familiar <5 salários mínimos. Nefropatia diabética foi a principal etiologia (25%) e 77% eram hipertensos. Houve 9% de referenciamento tardio. A maioria iniciou em diálise por DP (53%), sendo 58% de forma emergencial. Os pacientes permaneceram em DP por, em média, 710,5 dias. Foram implantados 676 cateteres peritoneais, média de 1,19/paciente. A maioria dos pacientes (59%) não apresentou peritonite. O índice global de peritonite foi de 0,32 episódio/paciente.ano. O Staphylococus aureus foi o germe mais prevalente (23%). Houve cura da peritonite em 71% dos casos. Identificou-se maior risco de peritonite nos pacientes com histórico de infecção do sítio de saída do cateter peritoneal. A sobrevida mediana da técnica de DP foi de 83,1 meses, com taxa de 85,1% em 2 anos e de 61,1% em 5 anos. A sobrevida mediana dos pacientes foi de 32,9 meses para os pacientes sem DM, com taxa de sobrevida em 2 anos de 52,4% e em 5 anos de 22,3%. Foram a óbito 353 indivíduos (62%). A etiologia da doença renal foi identificada em 37% dos casos. A chance de risco (OR) de óbito de quem tem referenciamento tardio é 2,032 vezes maior do que quem fez tratamento conservador. Como conclusão obteve-se que a despeito dos indicadores sociais ruins da população estudada, sobrevida, taxas de peritonite e complicações se assemelharam ao descrito na literatura. / Aracaju, SE

A doença renal crônica (DRC) tem sido considerada um problema de saúde pública mundial. Estima-se que cerca de 17% da população adulta dos EUA apresente algum grau de comprometimento da função renal. No Brasil, um estudo realizado na cidade de Bambuí - Minas Gerais detectou-se alteração da função renal variando de 0,48% a 8,19%, sendo mais frequente nos pacientes idosos. Os pacientes que evoluem para DRC terminal necessitam de algum tipo de terapia renal substitutiva (TRS), sendo as opções disponíveis: a hemodiálise (HD), a diálise peritoneal (DP) e o transplante renal (TX renal). No caso da DP, a membrana peritoneal realiza a função de filtrar o sangue do paciente, e esta é utilizada através da implantação de um cateter na cavidade abdominal. No Brasil, segundo dados do Censo Brasileiro de Diálise (2016) existem aproximadamente 122.825 pacientes em diálise, sendo 8,6% em DP. O objetivo do estudo foi analisar a evolução dos pacientes que foram admitidos na Unidade de Diálise do HCFMRP para submeterem-se à DP nos últimos 22 anos. Os dados foram coletados dos prontuários dos pacientes atendidos no período de 1993 a 2015, de onde foram extraídas variáveis demográficas, clínicas e laboratoriais. É um estudo de coorte retrospectiva de 199 prontuários de pacientes atendidos na Unidade de Diálise do HCFMRP-USP. Os resultados demonstram que a população do estudo é em sua maioria do sexo feminino, com média de idade 57 anos. Foi encontrada a mudança de TRS para a hemodiálise como desfecho clínico mais frequente, seguida por óbito. A etiologia da DRC mais frequente foi a hipertensão arterial sistêmica (HAS), seguida por Diabetes mellitus (DM) tipo 2. Houve associação com menor média de idade de entrada em programa (48 anos), desfecho clínico óbito e maior tempo de seguimento (10 anos) com o grupo de pacientes que entraram em programa de diálise em 1993 (p<0,05). Encontramos associação do uso de medicamentos (Cloridrato de Sevelamer e Análogos da vitamina D3 com níveis categorizados de paratormônio, cálcio total e fósforo (p<0,05). CONCLUSÃO: Os pacientes que entraram em programa no período de 1993-2000 apresentaram menor média de idade e maior tempo de acompanhamento quando comparados aos demais grupos. O desfecho clínico mais frequente foi a transferência para HD, tendo como causa principal a ocorrência de peritonites. / INTRODUCTION: Chronic kidney disease (CKD) has been considered a worldwide public health problem, as well as the progressive increase of the population in renal replacement therapy (TRS). With the technological advances accumulated, the survival of patients on dialysis has increased greatly. Peritoneal dialysis (PD) is considered a safe and effective method of SRT, a challenge for the binomial patienthealth team. OBJECTIVES: To analyze the main characteristics and outcomes of patients in a PD program. METHODS: This was a retrospective cohort study of 199 patients submitted to PD in the Dialysis Unit of the HCFMRP-USP from 1993 to 2015. The primary source of data was the individual medical records. The variables were classified as: demographic, clinical and laboratorial. Statistical analyzes were performed using the Chi-square test, ANOVA and Kruskal Wallis. RESULTS: The mean age of the patients was 57 years, with a predominance of females (51.5%); the most frequent clinical outcome was the change in HRT for hemodialysis (37.2%). Type 2 diabetes mellitus (DM) was the most common cause of CKD (31,7). There was an association between lower mean age of program entry, clinical outcome and longer follow-up (10 years) in the group of patients who entered the dialysis program in the period from 1993 to 2000 (p <0.05). There was an association between the use of medications (Sevelamer\'s Hydrochloride and vitamin D3 analogues) with categorized values of parathormone, total calcium and phosphorus (p <0.05). CONCLUSION: Patients who entered the program in 1993-2000 had a lower mean age and longer follow - up when compared to the other groups. The most frequent clinical outcome was the transfer to HD, the main cause being the occurrence of peritonitis.

Background: Complications related to peritoneal dialysis (PD) in patients with autosomal-dominant polycystic kidney disease (ADPKD), including intraperitoneal rupture of renal cyst, hernia, membrane failure and peritonitis, have been reported. However, long-term clinical outcomes of ADPKD patients on PD remain unclear. We performed this meta-analysis to assess the risks of death, technique failure and peritonitis in ADPKD patients on PD. Methods: A systematic review was conducted using MEDLINE, EMBASE and Cochrane databases from inception to October 2017 to identify studies that evaluated the outcomes of ADPKD patients on PD, including the risks of death, technique failure and peritonitis. Non-ADPKD patients on PD were used as controls. Effect estimates from the individual study were extracted and combined using the random-effect, generic inverse variance method of DerSimonian and Laird. Results: Twelve cohort studies with a total of 14 673 patients on PD (931 ADPKD and 13 742 non-ADPKD patients) were enrolled. Compared with non-ADPKD status, ADPKD was associated with significantly decreased mortality risk with pooled odds ratio (OR) of 0.68 (95% confidence interval (CI), 0.53–0.86; I 2 = 0). There were no associations of ADPKD with the risks of technique failure of PD and peritonitis with pooled OR of 0.93 (95% CI, 0.79–1.10; I 2 = 0) and 0.88 (95% CI, 0.75–1.05; I 2 = 0), respectively. We found no publication bias as assessed by Egger's regression asymmetry test, with P = 0.90, 0.28 and 0.60 for the risks of mortality, technique failure and peritonitis in ADPKD patients on PD, respectively. Conclusion: Compared with non-ADPKD patients on PD, our study demonstrates that ADPKD patients on PD have 0.68-fold decreased mortality risk. There are no associations of ADPKD status with the risks of technique failure or peritonitis.

Syftet med denna studie var att undersöka hur personer med egenadministrerad peritonealdialys (PD) upplever sitt dagliga liv. Metoden var en intervjustudie där sju personer som behandlades med PD intervjuades med hjälp av en semistrukturerad intervjuguide. Materialet som analyserades med en manifest kvalitativ innehållsanalys resulterade i tre huvudkategorier: kroppsliga förändringar, upplevelser av PD-behandling samt egenvård. Resultatet visade att PD hade inverkan på olika plan i informanternas dagliga liv. Ett viktigt fynd var hur informanterna uppfattade att PD hade lett till vissa kroppsliga förändringar, exempelvis vad gäller vikt och aptit. Det mest framträdande fyndet var emellertid att PD ledde till en bundenhet, vilket orsakade en oönskad passivitet hos informanterna. Det framkom dessutom att de informanter som väntade på njurtransplantation upplevde att denna väntan ledde till mer inskränkning i det dagliga livet än vad PD gjorde. Informanterna beskrev även de positiva aspekterna av PD-behandlingen och betonade fördelen med att PD möjliggjorde en självständighet och en flexibilitet. Denna studie gav ett brett perspektiv av hur personer med PD upplever sitt dagliga liv och visade att det inte bara är de kroppsliga förändringarna som påverkar personerna utan att PD även leder till känslor av bundenhet och passivitet. / The purpose of this study was to explore how people with self-administered peritoneal dialysis (PD) experience their daily life. The method was an interview study in which seven people who were treated with PD were interviewed using a semistructured interview guide. The material was analyzed with a manifest content analysis and resulted in three main categories: bodily changes, sensations of PD treatment and self-care. The results showed that PD had an effect in different levels in the informants’ daily lives. One important finding was how the informants perceived that the PD had led to certain bodily changes for example in terms of weight and appetite. The most striking finding, however, was that the PD led to a lack of freedom causing an undesirable passivity of the informants. It also showed that respondents who were waiting for kidney transplantation felt that this anticipation led to more restriction in daily life than PD did. The informants also described the positive aspects of PD treatment and stressed advantages such as that PD allowed autonomy and flexibility. This study gave a broad perspective of how people with PD experience their daily life and showed that not only the physical changes affected them but also led to feelings of restraint and passivity.

This report seeks to describe the status of kidney disease and renal replacement therapy in lower-resource settings, particularly sub-Saharan Africa. Acute kidney injury and transplantation are included on a limited basis because it is impossible consider the renal replacement therapy landscape at the exclusion of either. As in the rest of the developing world, chronic kidney disease and end-stage renal disease place a sizable and rapidly growing burden on sub-Saharan Africa, and Africans face a double-burden of disease from communicable and non-communicable diseases. Meanwhile, renal replacement therapy and the subspecialty of nephrology are expanding in sub-Saharan Africa, from non-existence in many countries to a limited, tentative subsistence, largely with the support of international organizations and the dedication of local nephrologists. Hemodialysis is the most common form of renal replacement therapy in sub-Saharan Africa, but peritoneal dialysis services, particularly for acute kidney injury, are growing and renal transplants are performed in a few sub-Saharan countries. Nonetheless, in the majority of sub-Saharan Africa, maintenance dialysis is still only available to the wealthy urban few. Although peritoneal dialysis may seem more feasible in the developing world than hemodialysis for multiple reasons, it is still fraught with challenges that make widespread implementation presently unadvisable. As renal replacement therapy is costly and currently unaffordable on a large scale for most of these countries, emphasis must be on identifying at-risk populations through screening and low-cost treatment or management of risk factors to mitigate chronic kidney disease.

Patients with chronic kidney failure, given that it is impossible to undergo transplantation, have to be treated by lifelong hemodialysis (HD) via extracorporeal circulation machine 3 times a week in hospital; or by peritoneal dialysis (PD) performed by patients at home. There were a number of studies comparing quality of life between HD and PD, but there have been fewer studies covering other psychological variables. The aim of this study was to examine whether HD and PD patients differ in social support, locus of control, coping and depressive symptoms. 143 HD patients (average age 65,56; 48,3 % men, 51,3 % women) and 48 PD patients (average age 63,79; 66,7 % men, 33,3 % women) were approached by random selection. Social Integration Survey (SIS) was applied to examine social support. Locus of control was depicted on visual analog scale. Coping strategies were mapped by a short version of COPE questionnaire - Brief COPE, which was translated to Czech language for this purpose. Beck's depression inventory (BDI - II) was used to evaluate incidence of depressive symptoms. Based on data statistical analysis there was no difference proved in social support, coping strategies, locus of control and depressive symptoms among HD and PD patients. Although HD and PD differ and cause diverse advantages and...

INTRODUÇÃO: A avaliação da QV tem se destacado de modo crescente em pesquisas clínicas de pacientes com insuficiência renal crônica terminal (IRCT), sendo o SF-36 um dos instrumentos mais utilizados nesta população. O objetivo deste estudo foi avaliar e comparar a QV nos pacientes com IRCT que estavam em tratamento dialítico de DPA e HD utilizando o SF-36 e avaliar se parâmetros sociais, demográficos, econômicos, clínicos e de adequação em diálise interferem na QV desses grupos. MÉTODOS: este estudo transversal, prospectivo e observacional, foi realizado em uma unidade de diálise satélite no município de São Paulo, em dezembro de 2003. Foram incluídos no estudo os pacientes de DPA ou HD, com tempo na terapia maior que 90 dias, idade entre 18 e 75 anos, com domínio da língua portuguesa e que concordaram em responder o instrumento para avaliação da QV. Participaram 22 pacientes de DPA e 79 de HD. Através do prontuário médico, foram coletados dados demográficos, sociais, econômicos, informações clínicas e exames laboratoriais. A QV foi avaliada apenas uma vez durante entrevista com a pesquisadora. Os valores obtidos na QV foram cruzados com as demais variáveis para verificar se havia interação significativa. RESULTADOS: Os grupos foram muito semelhantes entre si na maioria das variáveis analisadas. Na HD observou-se tempo maior de tratamento (p=0.002) e níveis de albumina sérica mais elevados que DPA (p<0,001). Em DPA, mais pacientes possuíam seguro saúde privado (p=0,018). A avaliação da QV é semelhante em quase todos os domínios do SF-36, a única diferença significativa ocorreu no Aspecto Físico, onde HD teve um escore maior que DPA (p=0,007). Não ocorreu nenhuma interação significativa entre este domínio e as demais variáveis analisadas que justificasse a diferença encontrada. CONCLUSÃO: A QV foi muito semelhante entre as duas modalidades de diálise. O grupo de HD apresentou melhor resultado em relação ao Aspecto Físico, sendo que este fato parece depender unicamente do método dialítico / The evaluation of health-related Quality of Life (Qol) is fundamental when searching for better treatment in end-stage renal disease (ESRD). The SF-36 is the most used questionnaire for this population. The purpose of this study was evaluated and compared the Qol in ESRD patients during either automatic peritoneal dialysis (APD) or hemodialysis (HD) treatment using the SF-36. METHODS: this is a prospective, cross-sectional and observational study, performed in a single dialysis facility in the city of São Paulo. Patients, with an age between 18 and 75 years, should be for more than 90 days in therapy and besides showing fluency in Portuguese language should be able to understand the questionnaire. Twenty-two APD and 79 HD patients were enrolled. The social, demographics, economics, clinical and laboratories information were colleted from the electronic data base. The Qol was assessed once an interview with one of the authors. The scores of SF-36 was correlated with the others variables to verify possible interactions. RESULTS: Both groups were very similar in most of the analyzed variables. Time in therapy was longer (p=0.002) and serum albumin level was higher (p<0,001) for the HD group than APD. In APD group more patients had private health insurance (p=0,018). The scores of SF-36 were similar in the various dimensions of the Qol questionnaire. The mean score for Physical Functioning was higher in HD than in APD (p=0,007). No significant interactions between the SF-36 dimensions and the others variables explained this difference. CONCLUSION: The Qol was very similar between these two dialysis modalities. The HD group showed better scores in Physical Functioning and this seemed to depend on the type of dialysis modality only

Introdução: Diálise peritoneal (DP) é a modalidade de diálise mais utilizada em pacientes pediátricos portadores de doença renal crônica (DRC) em todo o mundo. Peritonites e infecções de óstio e túnel do cateter de diálise peritoneal constituem as duas primeiras causas de morbidade e falha de tratamento em pacientes em programa de diálise peritoneal. Objetivo: Caracterizar o perfil dos episódios de peritonites e infecções de óstio e túnel nos pacientes em programa de diálise peritoneal crônica na Unidade de Nefrologia Pediátrica do Instituto da Criança do HC FMUSP. Métodos: Avaliou-se o período compreendido entre janeiro de 1994, quando foi iniciado o programa de diálise peritoneal crônica nessa unidade, e dezembro de 2005. Foram incluídos todos os pacientes que estiveram em programa de diálise peritoneal crônica no período, cujos prontuários estivessem acessíveis para análise. Realizou-se revisão dos prontuários quanto aos dados demográficos dos pacientes, peso e estatura ao início e ao final do programa de diálise, etiologia e evolução clinica de cada episódio infeccioso, e presença de fatores de risco para peritonites e infecções relacionadas ao cateter de DP. Realizou-se análise descritiva dos dados gerais, cálculo da incidência de episódios infecciosos no período estudado e freqüência de fatores de risco para infecção. Analisaram-se descritivamente os perfis de todos os episódios infecciosos. Resultados: Cinqüenta e três pacientes foram estudados, sendo 32 (60,4%) do sexo masculino, com mediana de idade de 9,5 (0,3 a 18,2) anos. A etiologia da DRC foi má-formação urológica em 32 (60,4%) pacientes, glomerulopatias em 15 (28,3%), tubulopatias em 4 (7,5%) e outras causas em 2 (3,8%). A mediana do tempo em diálise foi de 20,5 (3,9 a 87,1) meses. Houve 132 episódios infecciosos no período observado, em 42 (79%) pacientes, sendo 65 peritonites, 54 infecções de óstio e túnel e 13 infecções de óstio e túnel associadas a peritonite, num total de 1329,3 paciente-mês. Assim sendo, houve 0,49 infecções de óstio e túnel/ paciente-ano, 0,59 peritonites/ paciente-ano e 0,12 infecções de óstio e túnel associadas a peritonite/ paciente-ano. Os agentes mais encontrados nas infecções de óstio e túnel foram S. aureus, isolado em 23 culturas (43% das culturas de óstio positivas), Staphylococcus coagulase negativo em 7 (13%) e Pseudomonas aeruginosa em 7 (13%). Nas peritonites, os agentes mais encontrados foram S. aureus, isolado em 15 culturas (27% das culturas de líquido peritoneal positivas), Staphylococcus coagulase negativo em 13 (24%) e Acinetobacter baumanii em 4 (7%). Nos casos de peritonite associada a infecção de óstio e túnel, S. aureus foi isolado em 6 culturas (67% das culturas de secreção de óstio) e Staphylococcus coagulase negativo em 2 (22%). Staphylococcus sp, Pseudomonas aeruginosa e fungos foram os agentes mais relacionados a complicações como colonização do óstio, evolução para peritonite, necessidade de troca do cateter e perda funcional peritoneal. Devido ao reduzido número de pacientes que não apresentaram infecções, não foi possível identificar fatores de risco na casuística estudada. Conclusões: As taxas encontradas de peritonites e infecções de óstio e túnel são elevadas. Staphylococcus sp foram os agentes mais encontrados e um dos mais relacionados a complicações. Medidas profiláticas no sentido de diminuir a contaminação por esse agente podem constituir uma intervenção eficaz para a redução das taxas de infecção diálise-relacionadas. / Introduction: Peritoneal dialysis (PD) is one of the most frequently used modality of chronic dialysis in children presenting with end stage renal disease (ESRD) worldwide. Peritonitis and exit site and/or tunnel infections (ESI/TI) are the major causes of morbidity and treatment failure in patients undergoing peritoneal dialysis. Objective: To study the episodes of peritonitis and ESI/TI in patients undergoing maintenance peritoneal dialysis in the Pediatric Nephrology Unit of Instituto da Criança - HC FMUSP. Methods: All patients whose files were available for analysis were included. Data was collected from January 1994, at the beginning of the program of chronic peritoneal dialysis in this unit, until December 2005. Demographic data, weight and height at the start and at the end of the period of study, etiology and clinical outcome of each infectious episode and risk factors for peritonitis and catheter related infections, were analyzed. Descriptive analysis of demographic data was performed. Incidence rates of peritonitis and ESI/TI and frequency of possible risk factors rates were calculated. Results: Fifty three patients were studied, 32 (60.4%) male, with median age of 9.5 (0.3 to 18.2) years. Primary renal disease was urological malformation in 32 (60.4%) patients, glomerular diseases in 15 (28.3%), tubular diseases in 4 (7.5%) and other causes in 2 (3.8%). Median time on dialysis was 20.5 (3.9 a 87.1) months. In 1329.3 patient-month, 132 episodes of peritonitis and/or ESI/TI occurred in 42 (79%) patients, including 54 episodes of ESI/TI, 65 episodes of peritonitis and 13 episodes of peritonitis associated with ESI/TI, yielding an annualized rate of 0.49, 0.59 and 0.12 episodes/patientyear, respectively. The most frequent etiologic agents in the ESI/TI group were S. aureus, isolated in 23 exit site cultures (43% of positive cultures), Staphylococcus coagulase negative in 7 (13%) and Pseudomonas aeruginosa in 7 (13%). In the peritonitis group, the most frequent agents were S. aureus, isolated in 15 peritoneal fluid cultures (27% of positive cultures), Staphylococcus coagulase negative in 13 (24%) and Acinetobacter baumanii in 4 (7%). In the episodes of peritonitis associated with ESI/TI, S. aureus was isolated in 6 (67%) exit site cultures and Staphylococcus coagulase negative in 2 (22%). Complications such as exit site colonization, evolution to peritonitis, catheter removal and peritoneal failure were mostly associated with Staphylococcus sp, Pseudomonas aeruginosa and fungi infections. No risk factors could be identified due to the reduced number of patients not affected by infections. Conclusion: Peritonitis and ESI/TI rates in this population were high. Staphylococcus sp was the most frequently recovered agent. Infections caused by this agent presented a high rate of complications. Prophylactic measures to decrease contamination with this microorganism could be an efficient intervention to reduce dialysis associated infection rates.