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Peritonitis prevention in CAPD.

S Carozzi1, S Lamperi

  • 1Division of Nephrology, St. Martin's Hospital, Genova, Italy.

Clinical Nephrology
|January 1, 1988
PubMed
Summary
This summary is machine-generated.

Continuous ambulatory peritoneal dialysis (CAPD) patients with frequent peritonitis may benefit from intraperitoneal immunoglobulin G (IgG) therapy. Interferon therapy can be considered for patients with a poor response to IgG treatment.

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Area of Science:

  • Nephrology
  • Immunology

Background:

  • Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) often experience frequent peritonitis episodes.
  • Low immunoglobulin G (IgG) concentrations and reduced dialysate opsonic capacity are observed in CAPD patients with high peritonitis rates.

Purpose of the Study:

  • To evaluate the efficacy of intraperitoneal IgG therapy in reducing peritonitis episodes in CAPD patients.
  • To investigate the role of Fc-receptor expression and macrophage function in treatment response.
  • To explore the potential of interferon therapy for non-responders.

Main Methods:

  • A study involving 12 CAPD patients with frequent peritonitis.
  • Intermittent intraperitoneal IgG administration (12 g/3 weeks for 24 months).
  • Measurement of effluent IgG levels, dialysate opsonic capacity, interleukin-1 levels, and macrophage Fc-receptor expression.

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Main Results:

  • Intraperitoneal IgG therapy significantly increased dialysate opsonic capacity and reduced peritonitis rates (from 1.6 to 0.2 episodes/year).
  • Interleukin-1 levels showed a transient increase post-treatment.
  • Patients with lower clinical response exhibited transiently elevated IgG and opsonic capacity, with deficient macrophage Fc-receptors.
  • Intraperitoneal interferon-alpha improved macrophage function and dialysate bactericidal capacity in non-responders.

Conclusions:

  • Intraperitoneal IgG application is a viable treatment for high peritonitis rates in CAPD patients.
  • Intraperitoneal interferon should be considered for CAPD patients who show a poor response to IgG therapy, particularly those with Fc-receptor deficiencies.