Factors Influencing the symptom-to-contact Time in Patients with Peritoneal Dialysis-associated Peritonitis: A multi-center Retrospective Study

Background Delays in seeking medical attention lead to delays in the initiation of antibiotic therapy, prolonging the duration of illness in patients with peritoneal dialysis-associated peritonitis (PDAP). However, there is little information on the factors that lead to delays in seeking initial medical attention after the onset of symptoms.The aim of this study was to investigate the situation and factors influencing delayed consultation in PDAP patients. Methods Retrospective review of clinical and epidemiological data of all adult patients with peritoneal dialysis-associated peritonitis in three hospitals in Xiamen, China, who developed peritonitis between January 2022 and November 2024. Data were analysed with descriptive and inferential statistics (i.e. correlation and multiple linear regression) using the Statistical Package for Social Science Software version 27. Results A total of 134 patients were included in the current study, of whom 77 (57.46%) had symptom-to-contact time (SC)≦24h. Muddy dialysate was the most common presenting symptom (73.9%), while 67.9% had abdominal pain and 52.99% had both. Multivariate analysis showed that residence (OR=3.133, 95% CI: 1.531-6.413)、peritoneal dialysis modality (OR=0.097, 95% CI: 0.012-0.767)、abdominal pain (OR=3.991, 95% CI: 1.854-8.590)、dissolving dialysate (OR=3.095, 95% CI: 1.391-6.886) were independent predictors of symptom-to-contact time in patients with peritoneal dialysis-associated peritonitis (P<0.05). Conclusions A significant proportion of PDAP patients experienced delayed consultation, which is of concern as it may lead to exacerbation of peritonitis and adversely affect patient health outcomes. Specifically, PD modality, abdominal pain and sludgy dialysate were the influencing factors for delayed consultation in PDAP patients. It is suggested that targeted interventions in the management of PDAP patients are important to promote timely consultation and improve the prognosis of peritonitis. Trial registration Not applicable.