%0 Journal Article
%T Efficacy of sucrose and povidone-iodine mixtures in peritoneal dialysis catheter exit-site care.
%A Nakayama T
%A Morimoto K
%A Uchiyama K
%A Washida N
%A Kusahana E
%A Hama EY
%A Mitsuno R
%A Tonomura S
%A Yoshimoto N
%A Hishikawa A
%A Hagiwara A
%A Azegami T
%A Yoshino J
%A Monkawa T
%A Yoshida T
%A Yamaguchi S
%A Hayashi K
%J BMC Nephrol
%V 25
%N 1
%D 2024 May 2
%M 38698327
%F 2.585
%R 10.1186/s12882-024-03591-1
%X 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.
BACKGROUND: This study was approved by the Keio University School of Medicine Ethics Committee (approval number 20231078) on August 28, 2023. Retrospectively registered.