Metabolic differences between persistent and routine peritonitis in CAPD

Changes in 10 metabolic parameters (body weight, blood hemoglobin, and serum albumin, urea, creatinine, cholesterol, triglycerides, potassium, calcium and phosphorus) were compared in 28 episodes of routine peritonitis and 27 episodes of persistent peritonitis. These infections occurred in 20 CAPD patients, all of whom acquired both types of peritonitis on separate occasions. Coagulase-negative staphylococci predominated in the routine infections, while Staphylococcus aureus and Gram-negative bacilli, especially Pseudomonas, were associated with persistent peritonitis. Decreases during infection were significantly larger in persistent as compared with routine peritonitis episodes for all 10 nutritional parameters. Time required for recovery of all nutritional variables except serum potassium and urea was significantly longer in the persistent episodes. Persistent peritonitis led to peritoneal catheter loss in 13 of the 27 episodes and was associated with 4 deaths, while routine peritonitis was associated with neither catheter loss nor death. In contrast to routine peritonitis, persistent CAPD peritonitis is associated with severe malnutrition, considerable morbidity, and mortality.