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Peritonitis in continuous ambulatory peritoneal dialysis.

W G Smith, D J Tsakiris, B J Junor

    Scottish Medical Journal
    |April 1, 1986
    PubMed
    Summary

    Peritonitis is a major complication of continuous ambulatory peritoneal dialysis (CAPD). This study details peritonitis diagnosis and management in 66 CAPD patients, finding antimicrobial therapy effective in 60% of cases.

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    Area of Science:

    • Nephrology
    • Infectious Diseases

    Background:

    • Peritonitis is the most frequent complication of continuous ambulatory peritoneal dialysis (CAPD).
    • Understanding peritonitis incidence and causative agents is crucial for effective patient management.

    Purpose of the Study:

    • To describe the experience in diagnosing and managing peritonitis in CAPD patients.
    • To analyze the incidence, causative organisms, and treatment outcomes of peritonitis.

    Main Methods:

    • Retrospective analysis of 66 CAPD patients treated between 1979 and 1982.
    • Data collection on peritonitis episodes, including incidence, microbiology, and treatment response.

    Main Results:

    • Overall peritonitis incidence was 1 episode per 6.75 patient-months.

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  • Staphylococcus species accounted for 46% of episodes; 24% were culture-negative.
  • Catheter exit site infections were common and potentially predisposed to peritonitis.
  • Antimicrobial therapy was effective in 60% of peritonitis episodes; fungal infections were resistant.
  • 29% of patients required transfer to hemodialysis due to refractory or recurrent peritonitis.

    • Conclusions:

    • Peritonitis management in CAPD requires careful diagnosis and targeted antimicrobial therapy.
    • Catheter exit site care is important to prevent peritonitis.
    • A significant proportion of CAPD patients may require alternative dialysis modalities due to peritonitis complications.