Tuberculous peritonitis in a cohort of continuous ambulatory peritoneal dialysis patients

Area of Science:

• Nephrology
• Infectious Diseases
• Gastroenterology

Background:

• Continuous ambulatory peritoneal dialysis (CAPD) is a common treatment for end-stage renal disease.
• Peritonitis is a serious complication of CAPD, with various causative agents.
• Tuberculous peritonitis is a rare but severe form of peritonitis that can occur in CAPD patients.

Purpose of the Study:

• To report on the incidence and characteristics of tuberculous peritonitis in CAPD patients.
• To highlight diagnostic challenges and outcomes associated with this condition.
• To emphasize the importance of early diagnosis and treatment for preserving peritoneal membrane function.

Main Methods:

• Retrospective analysis of 4 CAPD patients who developed tuberculous peritonitis.
• Review of diagnostic methods including Mycobacterium tuberculosis detection, peritoneal biopsy, and PCR.
• Assessment of treatment strategies and patient outcomes.

Main Results:

• Four out of 155 CAPD patients (2.6%) developed tuberculous peritonitis.
• Diagnosis was confirmed through various methods, including PCR detection of Mycobacterium tuberculosis genes.
• Two patients experienced ultrafiltration failure; outcomes varied after treatment, with some progressing to hemodialysis and mortality.
• One patient successfully continued CAPD after catheter reimplantation and chemotherapy.

Conclusions:

• Tuberculous peritonitis should be suspected in CAPD patients with peritonitis unresponsive to conventional therapy.
• Prompt initiation of anti-tuberculosis chemotherapy is vital to preserve peritoneal membrane integrity.
• Early diagnosis and management can significantly impact patient prognosis and dialysis modality choices.