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Neutrophil function in patients on continuous ambulatory peritoneal dialysis
D M Harvey1, K J Sheppard, A G Morgan
1Department of Haematology, Nottingham City Hospital.
British Journal of Haematology
|March 1, 1988
Summary
Patients on continuous ambulatory peritoneal dialysis (CAPD) with peritonitis have abnormal neutrophil function. Neutrophils show reduced phagocytosis and impaired killing of Staphylococcus epidermidis, complicating treatment.
Area of Science:
- Nephrology
- Immunology
- Infectious Disease
Background:
- Peritonitis is a frequent complication in continuous ambulatory peritoneal dialysis (CAPD) patients.
- Neutrophil dysfunction may contribute to recurrent peritonitis in CAPD.
- Understanding neutrophil function is crucial for managing CAPD-related infections.
Purpose of the Study:
- To quantify phagocytosis and killing by neutrophils in CAPD patients.
- To compare neutrophil function in CAPD patients with and without peritonitis.
- To investigate the role of neutrophil defects in CAPD peritonitis outcomes.
Main Methods:
- Quantification of phagocytosis and intracellular killing assays.
- Analysis of circulating and peritoneal neutrophils.
- Comparison between CAPD patients with and without active peritonitis.
Main Results:
- Uninfected CAPD patients exhibited reduced neutrophil phagocytosis due to serum opsonization and neutrophil defects.
- Neutrophil phagocytosis was normal in CAPD patients experiencing peritonitis.
- Impaired killing of Staphylococcus epidermidis was observed, while Candida guilliermondii killing remained normal.
Conclusions:
- CAPD patients have inherent neutrophil defects affecting phagocytosis.
- Neutrophil activity increases during peritonitis, but killing of Staphylococcus epidermidis remains impaired.
- Defective Staphylococcus epidermidis killing may explain treatment resistance in CAPD peritonitis.