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Peritonitis in continuous ambulatory peritoneal dialysis patients in southern Israel
J Benjamin1, D Ben-Ezer Gradus, M Mostoslavski
1Department of Nephrology, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Insights
Continuous ambulatory peritoneal dialysis (CAPD) is a safe treatment for end-stage renal disease. This study found CAPD peritonitis rates varied by risk group, with Gram-positive bacteria being the most common cause.
Area of Science:
- Nephrology
- Infectious Diseases
Background:
- Peritonitis is a significant complication of Continuous Ambulatory Peritoneal Dialysis (CAPD).
- Understanding peritonitis incidence and causative agents is crucial for patient management.
Purpose of the Study:
- To report the experience of peritonitis in CAPD patients in southern Israel over a 3-year period.
- To analyze peritonitis incidence, risk factors, and outcomes in this patient population.
Main Methods:
- Retrospective review of 51 CAPD patients over 999 patient months.
- Analysis of 143 peritonitis episodes, categorizing patients into high and low-risk groups.
- Identification of causative organisms and assessment of recurrence rates.
Main Results:
- Overall peritonitis incidence was one episode every 5.7 months in high-risk and 13.2 months in low-risk groups.
- Gram-positive organisms caused 62.2% of infections, with coagulase-negative Staphylococcus accounting for 35%.
- Recurrence rate was 12%, with 7 patients requiring catheter removal and 3 transferred to hemodialysis.
Conclusions:
- CAPD is a safe and viable treatment for end-stage renal disease in the studied population.
- Risk stratification can inform peritonitis prevention and management strategies.
- Gram-positive bacteria, particularly coagulase-negative Staphylococcus, are the predominant pathogens.
Abstract:
We report our experience of peritonitis in a group of continuous ambulatory peritoneal dialysis (CAPD) patients in the south of Israel during a 3-year period. During this period, 51 patients were treated with CAPD, comprising a total of 999 patient months of treatment. One hundred and forty-three episodes of peritonitis occurred in 42 patients. When the patients were divided into high risk and low risk groups, the overall incidence was one episode every 5.7 months in the high risk group and one episode every 13.2 months in the low risk group. Gram-positive organisms accounted for 62.2% of the infections, and coagulase negative Staphylococcus for 35% of infections. The recurrence rate was 12%. Catheter removal was required in seven patients, and three patients were transferred to hemodialysis because of recurrent infections. We conclude that CAPD is a safe and viable modality of treatment for end-stage renal disease in our patient population.