Leukocyte kinetics in patients with peritonitis on long-term peritoneal dialysis

Dialysate and blood leukocyte counts were measured during 130 episodes of peritonitis in 91 hospitalized patients on long-term peritoneal dialysis (CPD). The authors found that the blood/dialysate leukocyte count can be less than 1.0, and this is usually the case when dialysate leukocyte count exceeds 20,000/mm3. Dialysate leukocyte removal in a single 2 L drain bag can approach the leukocyte number in the entire circulating blood volume. Daily drainage can remove leukocytes in amounts exceeding the blood leukocyte pool 2 to 3 fold. The observed blood leukocyte counts throughout a range of 2,700 to 10,000 at dialysate leukocyte counts greater than 20,000 per mm3 may reflect: 1) leukocyte removal approaching maximum bone marrow output of leukocytes, and/or 2) increasing microcirculatory margination of leukocytes in those episodes of peritonitis associated with very high dialysate leukocyte counts.