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Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
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Tuberculous peritonitis associated with peritoneal dialysis.

Abdelkarim Waness1, Saad Al Shohaib

  • 1Department of Internal Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates. n4alw@yahoo.com

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
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Tuberculous peritonitis (TBP) in continuous ambulatory peritoneal dialysis (CAPD) patients is rare but serious. Early treatment and catheter removal improve survival, often requiring a switch to hemodialysis.

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07:11

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Published on: July 19, 2018

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Tuberculous peritonitis (TBP) is a rare but severe complication in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
  • Managing TBP in CAPD patients presents challenges regarding dialysis modality continuation or switching to hemodialysis.
  • High tuberculosis prevalence and drug-resistant strains in regions like Jeddah necessitate careful consideration of TBP risks.

Purpose of the Study:

  • To determine the incidence of TBP in CAPD patients.
  • To evaluate patient survival rates and Tenckhoff catheter management post-TBP.
  • To assess the optimal dialysis modality following TBP infection.

Main Methods:

  • A retrospective cohort study analyzed 89 patients on CAPD over 12 years.
  • Investigated 103 episodes of peritonitis, identifying cases of TBP.
  • Diagnostic methods included polymerase chain reaction (PCR) and peritoneal fluid cultures for Mycobacterium tuberculosis.

Main Results:

  • Four cases of TBP were identified among 103 peritonitis episodes.
  • All four TBP patients survived their infection.
  • Tenckhoff catheter removal was necessary for all TBP patients, with conversion to hemodialysis.

Conclusions:

  • TBP in CAPD patients is a significant concern, particularly in high-prevalence areas.
  • Early anti-tuberculous therapy and Tenckhoff catheter removal are recommended for improved survival.
  • Most patients require conversion to hemodialysis, though some may restart CAPD after TBP recovery.