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Related Experiment Videos

Polymicrobial peritonitis in continuous ambulatory peritoneal dialysis patients.

G C Kim1, S M Korbet

  • 1Department of Medicine, Section of Nephrology, Rush-Presbyterian St Luke's Medical Center, Chicago, IL, USA.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|October 31, 2000
PubMed
Summary

Polymicrobial peritonitis is a serious complication in continuous ambulatory peritoneal dialysis (CAPD) patients, often occurring late and preceded by recurrent infections. While treatable, it leads to a poor long-term prognosis with high rates of hemodialysis transfer.

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Dialysis

Background:

  • Continuous ambulatory peritoneal dialysis (CAPD) is a common renal replacement therapy.
  • Peritonitis is a significant complication of CAPD, impacting patient outcomes.
  • Polymicrobial peritonitis represents a distinct and potentially severe form of CAPD-related infection.

Purpose of the Study:

  • To retrospectively evaluate the incidence, characteristics, and outcomes of polymicrobial peritonitis in CAPD patients.
  • To compare polymicrobial peritonitis with single-organism peritonitis and no peritonitis in terms of clinical course and sequelae.
  • To identify risk factors and long-term consequences associated with polymicrobial peritonitis in CAPD.

Main Methods:

  • Retrospective analysis of 232 CAPD patients from January 1, 1987, to December 31, 1997.

Related Experiment Videos

  • Categorization of patients into polymicrobial peritonitis, single-organism peritonitis, and no peritonitis groups.
  • Evaluation of peritonitis rates, causative organisms, identified intra-abdominal processes, catheter loss, and transfer to hemodialysis.

    • Main Results:

    • Polymicrobial peritonitis occurred in 16% of patients, accounting for 8% of all peritonitis episodes.
    • These infections occurred late (23 months) and were often preceded by >3 peritonitis episodes (73%).
    • Higher peritonitis rates (1.8 vs. 1.2 episodes/patient-year), greater catheter loss (65% vs. 30%), and significantly higher transfer to hemodialysis (70% vs. 25%) were observed in the polymicrobial group.

    Conclusions:

    • Polymicrobial peritonitis is an infrequent but serious late complication of CAPD, often linked to recurrent peritonitis.
    • Intra-abdominal processes are rarely the cause; infections are typically polymicrobial involving gram-negative, fungal, or gram-positive organisms.
    • Despite potential successful treatment without catheter removal, long-term outcomes are poor, necessitating a high rate of transfer to hemodialysis.