Objective Analyzed the factors of refractory peritoneal dialysis ⁃ associated peritonitis（rP⁃ DAP），To predict the probability of extubation in rPDAP patients. Methods A retrospective analysis was per⁃ formed on 164 patients who had regular follow ⁃ up in our hospital from January 2016 to December 2021 and had peritoneal dialysis⁃associated peritonitis（PDAP）. According to the clinical treatment results，the patients were di⁃ vided into refractory group and refractory group. The clinical data of the two groups were compared，and the influ⁃ encing factors of rPDAP occurrence and prognosis were explored by multivariate Logistic regression analysis. The risk prediction model of rPDAP extubation was established，and the diagnostic value of the predictive factors was analyzed by ROC curve. Results Among the two groups，66 patients were in refractory group and 98 were in re⁃ fractory group. Compared with non⁃refractory group，patients in refractory group had longer dialysis age［42.5（20， 64.5）months vs. 32.5（11.8，50.25）months］and lower serum albumin［（31.21±5.88）g/L vs.（32.99±5.20）g/ L］. Staphylococcus aureus and fungal infections were high（13.6% vs. 3.1% and 6.1% vs. 0）.Multivariate Logistic regression analysis showed that serum albumin level was negatively correlated with rPDAP development，but no cor⁃ relation was found with prognosis of patients（P < 0.05）. The extubation rate of patients with long dialysis age and multiple PDAP was positively correlated with that of patients with rPDAP（P < 0.05）. The area under ROC curve for predicting extubation risk of rPDAP was calculated based on dialysis age and multiple occurrence of PDAP. The diagnostic value of dialysis age was the largest，and the defined value of dialysis age was 54.5 months. Conclu⁃sion Serum albumin is an independent protective factor for rPDAP development. Long dialysis age and multiple occurrence of PDAP are of diagnostic value for extubation risk in rPDAP patients，and extubation risk is higher in rPDAP patients with dialysis age of 54.5 months or above.