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Tuberculous peritonitis in patients undergoing chronic home peritoneal dialysis

H P Holley, C T Tucker, T L Moffatt

    American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
    |January 1, 1982
    PubMed

    Insights

    Tuberculous peritonitis is a difficult diagnosis in patients undergoing chronic peritoneal dialysis. Its symptoms mimic bacterial peritonitis, complicating identification and treatment.

    Area of Science:

    • Nephrology
    • Infectious Diseases
    • Microbiology

    Background:

    • Peritonitis is a common complication of chronic peritoneal dialysis (CPD).
    • The cause of peritonitis is often unclear despite thorough investigation.
    • Tuberculosis (TB) incidence is rising in hemodialysis patients.

    Observation:

    • This study presents three cases of tuberculous peritonitis in patients on CPD.
    • Diagnosis was challenging due to absent signs of active TB and peritoneal fluid rich in polymorphonuclear leukocytes.
    • Peritoneal fluid analysis resembled bacterial peritonitis, differing from TB peritonitis in non-dialysis patients.

    Findings:

    • Tuberculous peritonitis can occur in patients undergoing chronic intermittent peritoneal dialysis.
    • Diagnostic indicators in peritoneal fluid may be misleading, mimicking bacterial peritonitis.
    • Early suspicion is crucial for patients with persistent or recurrent peritonitis.

    Implications:

    • Clinicians should consider tuberculous peritonitis in CPD patients with unexplained chronic or relapsing peritonitis.
    • This highlights the need for specific diagnostic approaches for TB in dialysis patients.
    • Timely diagnosis and treatment are essential to prevent complications in this vulnerable population.

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