[Personal 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 pts treated with continuous ambulatory peritoneal dialysis (CAPD) and 19 pts treated with standard intermitent peritoneal dialysis (SIPD). Mean incidence of peritonitis (P) was 1 episode per 9.0 patients-months. The important symptoms for early diagnosis of P were as follows: opacity of the 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.