Hierarchical management and precision intervention reduce peritonitis and improve hand hygiene in diabetic nephropathy peritoneal dialysis patients

Diabetic nephropathy (DN) is a major complication of diabetes, and many patients require peritoneal dialysis (PD). Peritonitis is one of the most frequent and serious complications in PD, often linked to inadequate hand hygiene. This study evaluated the impact of a hierarchical management and precision intervention program on peritonitis incidence and hand hygiene practices in diabetic nephropathy patients receiving PD. We enrolled 120 diabetic nephropathy patients on PD who were followed at our hospital between May and December 2022. All patients received hierarchical management and precision intervention measures. Outcomes were assessed using a general information survey, peritonitis incidence monitoring, and the "Knowledge-Attitude-Behavior (KAB) Survey" adapted for PD patients. The urea clearance index (KT/V) achievement rate among PD patients was moderate. After the intervention, significant improvements were observed in mask use, hand hygiene, aseptic technique, medical waste disposal, and self-protection behaviors. The incidence of peritonitis decreased to 6.67%, indicating a relatively low occurrence compared to baseline.Hierarchical management combined with precision intervention can effectively reduce PD-related peritonitis and improve hand hygiene knowledge and practices among diabetic nephropathy patients.