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Peritonitis during continuous ambulatory peritoneal dialysis

J Rubin, W A Rogers, H M Taylor

    Annals of Internal Medicine
    |January 1, 1980
    PubMed
    Summary
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    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.

    Related Experiment Videos

  • 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.