[Our experience with the diagnosis of peritonitis complicating a long-term program of peritoneal dialysis]

Among 37 patients (pts) with irreversible renal failure treated in years 1980-1990 with chronic peritoneal dialysis there were 18 treated with continuous ambulatory peritoneal dialysis (CAPD) and 19 treated with standard intermittent peritoneal dialysis (SIPD). Mean frequency of peritonitis (P) was 1 episode per 9.0 patients-months. The important symptoms for early diagnosis of P were as follows: cloudiness of peritoneal effluent (PE) and high (more than 50%) percentage of polynuclear cells in the smear of PE sediment. Positive results of PE culture were obtained only in 50% of P episodes in years 1980-1985, mostly in pts treated with CAPD (17/21 pts). In the period of 1986-1990, in pts treated mostly with SIPD (15/16 pts), positive results were obtained in 80% of P. Improvements of bacteriological diagnosis of P, especially in pts treated with CAPD, were discussed. "Prophylactic" cultures of PE were found to be of no value.