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Repeat peritonitis in peritoneal dialysis: retrospective review of 181 consecutive cases

Cheuk-Chun Szeto1, Bonnie Ching-Ha Kwan, Kai-Ming Chow

  • 1Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. ccszeto@cuhk.edu.hk

Clinical Journal of the American Society of Nephrology : CJASN
|December 25, 2010
PubMed
Abstract

Insights

Repeat peritonitis, defined as infection with the same organism after treatment, is a distinct clinical issue. While antibiotic treatment is often effective, patients face a significant risk of further peritonitis episodes.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Peritonitis, a common complication in peritoneal dialysis, can recur.
  • The clinical characteristics and outcomes of repeat peritonitis episodes are not well understood.

Purpose of the Study:

  • To compare the clinical behavior and outcomes of repeat peritonitis with relapsing and control peritonitis episodes.

Main Methods:

  • A retrospective study comparing 181 episodes of repeat peritonitis with 91 episodes of relapsing peritonitis and 125 episodes of control peritonitis.
  • Outcomes analyzed included cure rates, response rates, catheter removal, and mortality.

Main Results:

  • Staphylococcus aureus was a more common cause of repeat peritonitis (24%) than relapsing (5.5%) or control (15%) peritonitis.
  • Repeat peritonitis showed a lower complete-cure rate (70.7%) compared to relapsing peritonitis (54.9%) but similar primary response, catheter removal, and mortality rates.
  • Repeat peritonitis had a higher primary response rate (89.0%) and lower catheter removal rate (6.1%) than control peritonitis, with similar cure rates and mortality.

Conclusions:

  • Repeat peritonitis represents a unique clinical entity.
  • Antibiotic therapy for repeat peritonitis generally yields satisfactory results but carries a substantial risk of subsequent relapsing or repeat peritonitis.

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