Impact of ISPD Guidelines and the COVID-19 Pandemic on Peritoneal Dialysis Peritonitis Rates: A Retrospective Cohort Study

Abstract This retrospective cohort study investigates the impact of prophylactic measures on Peritoneal Dialysis (PD) related peritonitis, with a particular focus on contrasting periods before and after the onset of the COVID-19 pandemic.1 The research entailed an analysis of patient data over several years, centred on the implementation of the International Society for Peritoneal Dialysis (ISPD) guidelines.2 Methodologically, the study contrasts PD peritonitis rates, types of causative organisms, peritonitis-related hospitalization frequencies, and mortality rates before and after the reinforcement of ISPD guidelines. The results revealed a notable decrease in the overall incidence of PD peritonitis post-implementation of these guidelines. However, the COVID-19 pandemic period showed a temporary reversal of this trend, with an increase in peritonitis rates, likely due to disrupted healthcare services and altered patient behaviours during the pandemic.3 Furthermore, our analysis highlighted a shift in the microbiological profile of peritonitis-causing organisms in the post-pandemic period. The study's findings illuminate the dynamic nature of PD peritonitis management in response to major healthcare interventions and global health crises. The decreased peritonitis rates post-ISPD guidelines underscore their effectiveness, while the pandemic's impact reveals vulnerabilities in healthcare delivery during crises. These insights are pivotal for shaping future PD management strategies and enhancing patient care in both standard and challenging healthcare environments.