Related Experiment Video
Updated: Aug 19, 2026
Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
Published on: July 19, 2018
[Treatment of peritonitis in continuous ambulatory peritoneal dialysis ]
Unlabelled:
Thirty patients were treated with continuous ambulatory peritoneal dialysis during 313 patients months. 26 episodes of peritonitis defined by a cloudy dialysate with more than 100 cells/mm1 and more than 50 p. cent of polynuclear were observed. The organisms initially responsible were Gram-positive in 11 cases (6 Staphylococcus aureus, 1 Staphylococcus albus, 4 Streptococcus viridans), a gram negative in 3 cases (1 Klebsiella, 1 serratio, one unidentified), a Candida in 2 cases. In 10 cases, the culture was negative, Initial treatment was peritoneal lavage (40 l/day) with in situ antibiotics: in the absence of Candida, the association sulfamethoxazole (SMZ) (80 mg/l) and trimethoprim (TMP) (16 mg/l) was used; when Candida was present amphotericin B (5 mg/l) was used. The association SMZ + TMP led to cure of PT in 17 cases, in 7 +/- 4 days. In 5 cases, this initial treatment was changed at the 48th hour because of initial resistance in one case or secondary resistance of Candida surinfection (2 cases). Candida surinfection occurred later in 2 other cases. For these 6 primary or secondary Candida peritonitis, the catheter was changed within 48 hours. Nevertheless, death occurred in 3 cases and cure was obtained after 51 +/- 11 days in the 3 other cases.
Conclusions:
1) The initial treatment by SMZ + TMP appears quite effective in most cases (73%). 2) The severity and the high incidence of Candida surinfection suggest that its systematic prophylaxis may be appropriate.
Insights
Continuous ambulatory peritoneal dialysis patients experienced peritonitis episodes. Sulfamethoxazole (SMZ) and trimethoprim (TMP) effectively treated most cases, but Candida infections posed significant risks, suggesting prophylaxis is needed.
Area of Science:
- Nephrology
- Infectious Diseases
- Microbiology
Context:
- Continuous ambulatory peritoneal dialysis (CAPD) is a common treatment for end-stage renal disease.
- Peritonitis is a serious complication of CAPD, leading to treatment failure and increased morbidity.
- Understanding the causative organisms and effective treatment strategies for CAPD-related peritonitis is crucial.
Purpose:
- To evaluate the efficacy of sulfamethoxazole (SMZ) and trimethoprim (TMP) in treating peritonitis in CAPD patients.
- To assess the incidence and impact of Candida species in CAPD-related peritonitis.
- To determine optimal management strategies for peritonitis, including the potential need for Candida prophylaxis.
Summary:
- Thirty patients undergoing CAPD experienced 26 peritonitis episodes, with Gram-positive organisms being the most common initial cause.
- Initial treatment with SMZ and TMP demonstrated a 73% cure rate for peritonitis, with a mean recovery time of 7 days.
- Candida species caused significant complications, including secondary infections and a high mortality rate (3 out of 6 cases), highlighting the need for prophylactic measures.
Impact:
- The findings support the use of SMZ + TMP as an effective first-line treatment for CAPD peritonitis.
- The high incidence and severity of Candida peritonitis underscore the importance of considering antifungal prophylaxis in at-risk CAPD patients.
- This study contributes to optimizing CAPD management protocols to reduce peritonitis-related complications and improve patient outcomes.
Related Concept Videos
01:26Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
01:30Peritoneal Dialysis I: Introduction and Procedure
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
01:25Peritoneal Dialysis III: Nursing Management
01:30Continuous Renal Replacement Therapy
01:20Acute Kidney Injury V: Interprofessional Care