In March, 2022, the latest edition of International Society for Peritoneal Dialysis (ISPD) Guideline on Prevention and Treatment of Peritonitis was released, in which the definition, indexes, risk factors and outcomes related to peritonitis were revised, and the diagnostic techniques and treatment of peritonitis were updated. Specifically, vancomycin is still recommended to cover Gram-positive bacteria when antibiotics are chosen for empirical anti-infection treatment. It is worth mentioning that regarding the controversial issue of the time reaching vancomycin trough concentration in the guideline, the conclusion of a cohort study of peritoneal dialysis entitled "Exploration of vancomycin concentration and dosage in empirical treatment of peritoneal dialysis-related peritonitis" conducted by the First Affiliated Hospital of Xi 'an Jiaotong University (XJTU) was cited, which fully recognized the work of peritoneal dialysis in China.
Our hospital initiated peritoneal dialysis-related work in 1981. A special management team of peritoneal dialysis was set up, the follow-up files of peritoneal dialysis patients were established and relevant data management was standardized, becoming the pioneer to conduct nationwide cohort study of peritoneal dialysis. By adhering to the management concept of "management first, treatment second", the peritoneal dialysis team improves the management quality in multiple aspects including nutrition, rehabilitation, patient education, psychological guidance and dynamic follow-up, and strives to achieve “the highest efficacy with the smallest dose of medicine”. More than 2,000 peritoneal dialysis patients have been registered in Department of Nephrology. The quantity of peritoneal dialysis patients receiving regular follow-up has been constantly increased up to over 950 cases, with the longest duration of peritoneal dialysis of 18 years. Our hospital ranks among Top 4 large-scale peritoneal dialysis centers in China.
The team has successively carried out laparoscopic peritoneal dialysis catheterization under general anesthesia, reduction of peritoneal dialysis catheter and release of omentum wrapping, repair of peritoneal dialysis complicated with inguinal hernia, percutaneous catheterization using modified Sedinger technique and non-invasive removal of peritoneal dialysis catheter. Ultrasound-guided transverse abdominal muscle plane block anesthesia not only significantly improves the efficiency of peritoneal dialysis catheterization, but also considerably mitigates intraoperative pain of patients. In addition, the application of indocyanine green in the diagnosis of thoracoabdominal fistula and abdominal wall leakage during peritoneal dialysis has filled the gap around the globe and captivated widespread attention from experts worldwide at international conferences. The "modified step-by-step peritoneal dialysis treatment mode" proposed by Professor Lyu Jing not only remarkably improves the dialysis quality, but also saves medical costs and enhances the patients' compliance. At present, our hospital is also one of the few affiliations in northwest China which can carry out peritoneal dialysis treatment for newborns, small children, children, adults and critically ill patients. Besides, Department of Nephrology along with Department of Kidney Transplantation and Department of Blood Purification drive our hospital to become one of the strongest kidney disease hospitals in China.
