Objective:
Ever since the introduction of peritoneal dialysis in the management of renal failure, complications related to technique, particularly peritonitis, have restricted its wider use and acceptance in continuous ambulatory peritoneal dialysis (CAPD) patients. In this study, we aimed to determine the frequency, most common causative agents and risk factors for peritonitis among our CAPD patients.
Material and Methods:
We included 132 CAPD patients (63 M, 69 F; age: 40.41±14.17 years, CAPD duration: 38.27±18.60 months) followedup in our peritoneal dialysis center between January 1996-December 2003. Peritonitis was defined as the presence of organisms on gram stain or culture of peritoneal dialysis fluid, leukocytes greater than 100 cells/mm3, neutrophil count >50% of the dialysate or symptoms of peritoneal inflammation. The patients were divided into three groups according to the number of peritonitis attacks; Group I= No attacks of peritonitis; Group II= 1 attack of peritonitis; Group III= ≥2 attacks of peritonitis. The patients in Group III were further evaluated for the presence of underlying risk factors for the development of peritoneal infection.
Results:
We observed no attacks in 74 patients, 1 attack in 42 patients and ≥2 attacks in 16 patients. Mean number of attacks was 2.31±0.47. The major causative microorganisms of peritonitis in our CAPD patients were Staphylococcus aureus and Staphylococcus epidermidis. The further evaluation of the patients with ≥2 attacks revealed that concomitant diabetes mellitus, secondary organ tuberculosis, and amyloidosis came forward as underlying risk factors for repeated peritonitis.
Conclusions:
Concomitant diabetes mellitus, secondary organ tuberculosis, and amyloidosis were risk factors in CAPD patients with repeated episodes of peritonitis. Our results emphasize that in patients with repeated attacks; patients’ risk factors must be carefully evaluated, (if possible) eliminated, and appropriately treated.
Keywords: Peritoneal dialysis, peritonitis, risk factors