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Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis: a single-centre experience in India

R Ram1, G Swarnalatha, P Neela

  • 1Nizam's Institute of Medical Sciences, Hyderabad, India. ram_5_1999@yahoo.com

Nephron. Clinical Practice
|November 1, 2008
PubMed
Abstract

Insights

Fungal peritonitis (FP) in continuous ambulatory peritoneal dialysis (CAPD) patients is linked to specific risk factors. Low serum albumin and leaving the catheter in place predict mortality in these patients.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Fungal peritonitis (FP) is a serious complication in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
  • Understanding the risk factors for FP and its associated mortality is crucial for improving patient outcomes in end-stage renal disease (ESRD).

Purpose of the Study:

  • To examine the clinical features, treatment, and outcomes of fungal peritonitis in CAPD patients.
  • To identify risk factors associated with contracting FP and mortality due to FP.

Main Methods:

  • Retrospective review of dialysis records for 303 end-stage renal disease (ESRD) patients initiated on CAPD between January 1998 and February 2008.
  • Analysis of peritonitis episodes, including fungal and bacterial types, and associated patient factors.

Main Results:

  • 43 episodes of fungal peritonitis (FP) were recorded, accounting for 23.88% of all peritonitis episodes.
  • Predictors of mortality included non-Candida species, catheter in situ, and serum albumin <3 g/dl; multivariate analysis confirmed catheter in situ and low serum albumin as significant predictors.
  • Risk factors for contracting FP included prior intraperitoneal antibiotic use and low serum albumin.

Conclusions:

  • Specific risk factors for contracting fungal peritonitis have been identified in CAPD patients.
  • Key predictors of mortality in fungal peritonitis include the presence of the peritoneal dialysis catheter and low serum albumin levels.

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