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Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
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Published on: July 19, 2018

Peritonitis during continuous ambulatory peritoneal dialysis

J Rubin, W A Rogers, H M Taylor

    Annals of Internal Medicine
    |January 1, 1980
    PubMed

    Insights

    Continuous ambulatory peritoneal dialysis for chronic renal failure led to frequent peritonitis, increasing hospitalizations and negating cost benefits. Preventing peritonitis is crucial for this therapy to succeed.

    Area of Science:

    • Nephrology
    • Infectious Diseases
    • Medical Procedures

    Background:

    • Continuous ambulatory peritoneal dialysis (CAPD) is a treatment for chronic renal failure.
    • Technical aspects of CAPD can lead to peritonitis, a serious complication.
    • Effective prevention strategies for peritonitis are needed to ensure CAPD's viability.

    Purpose of the Study:

    • To evaluate the incidence and microbiology of peritonitis in a CAPD program.
    • To assess the effectiveness of intraperitoneal cephalothin in treating peritonitis.
    • To determine the impact of peritonitis on hospitalization and the overall success of CAPD.

    Main Methods:

    • A therapeutic program of CAPD was initiated for patients with chronic renal failure.
    • Microbiologic evaluation of 97 peritonitis episodes was performed.
    • Dialysate cell counts and gram stains were utilized for diagnosis.
    • Treatment efficacy was assessed using intraperitoneal cephalothin.

    Main Results:

    • 73% of peritonitis episodes were culture-positive, predominantly by gram-positive organisms early on and gram-negative rods later.
    • Dialysate gram stains had a low positivity rate (9%).
    • Dialysate cell counts reliably indicated peritoneal inflammation and treatment response.
    • Peritonitis led to significant hospitalization, offsetting financial benefits of CAPD.

    Conclusions:

    • Peritonitis is a major challenge in CAPD, significantly impacting patient outcomes and treatment economics.
    • While cephalothin showed efficacy, peritonitis prevention remains paramount for successful CAPD therapy.
    • Further advancements in CAPD techniques are necessary to minimize peritonitis incidence.

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