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Culture-negative CAPD peritonitis: the Network 9 Study

M Bunke1, M E Brier, T A Golper

  • 1Academic Committee of Network 9, University of Louisville, Kentucky.

Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis
|January 1, 1994
PubMed
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Initial no growth peritonitis (INGP) in peritoneal dialysis (PD) patients is more common in older adults and may require longer intraperitoneal (IP) therapy. INGP outcomes are similar to culture-positive peritonitis, with less catheter removal.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Peritoneal Dialysis

Background:

  • Peritonitis is a common complication of peritoneal dialysis (PD).
  • Some peritonitis episodes are culture-negative, termed initial no growth peritonitis (INGP).
  • Understanding INGP characteristics is crucial for PD patient management.

Purpose of the Study:

  • To compare demographics, symptoms, signs, treatment, and outcomes of INGP versus culture-positive (Pos) peritonitis.
  • To identify factors associated with INGP in PD patients.

Main Methods:

  • Analysis of data from the Network 9 Peritonitis and Catheter Survival Study.
  • Inclusion criteria: PD patients with fluid WBC counts > 100.
  • Comparison of INGP (14% of episodes) with Pos peritonitis.

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Main Results:

  • INGP patients were older (≥70 years) and more likely to use dialysate additives.
  • No significant differences in gender, race, diabetes, previous peritonitis, or exit-site infections.
  • INGP group had a lower catheter removal rate but similar hospitalization, death, and hemodialysis switch rates.
  • INGP patients received longer intraperitoneal (IP) therapy (7-10 days vs. ≤6 days).

Conclusions:

  • INGP is a distinct subgroup of peritonitis in PD patients, often affecting older individuals.
  • While INGP shows a lower rate of catheter removal, outcomes are otherwise comparable to culture-positive peritonitis.
  • Longer duration of intraperitoneal therapy may be indicated for INGP cases.