Fungal Peritonitis in Peritoneal Dialysis: Risk Factors and Prognosis
- 1 January 2009
- journal article
- Published by Taylor & Francis Ltd in Renal Failure
- Vol. 31 (1), 25-28
- https://doi.org/10.1080/08860220802546446
Abstract
Although less common than bacterial peritonitis, fungal peritonitis is associated with much higher morbidity and mortality. In this study, we aimed to determine the risk factors for fungal peritonitis in peritoneal dialysis patients. The records of 109 peritoneal dialysis patients were analyzed. A total of 86 episodes of peritonitis attacks were recorded. Nine (10.5%) of these attacks were fungal peritonitis attacks. The fungal peritonitis attack rate of the population was 1 attack per 480.1 patient months. In order to determine predisposing factors for fungal peritonitis patients, patients with bacterial peritonitis and with no peritonitis admitted immediately before and after those with fungal peritonitis were used as controls. There was no statistically significant difference between the bacterial and fungal peritonitis groups with respect to symptoms and signs. Obligatory peritoneal dialysis treatment due to access or other medical problems (p = 0.04) and serum albumin levels (p = 0.01) were found to be significantly related with fungal peritonitis (p = 0.04). The mortality rate was 11.1%. When compared with the mortality rate of bacterial peritonitis (1.8%) during the same period, it was found to be significantly higher (p = 0.0001). The catheter removal was performed within 2-7 days (mean = 5.2 days) of the fungal peritonitis attacks. In conclusion, we decided that because fungal peritonitis attacks end up with high morbidity and mortality, prompt diagnosis and removal of the catheter is mandatory. Diagnosis highly depends on culture results, as signs and symptoms usually do not differ from that of bacterial peritonitis. Low serum albumin levels and obligatory peritoneal dialysis treatment are found to be the risk factors for fungal peritonitis.Keywords
This publication has 9 references indexed in Scilit:
- Comparison of Incidence of Peritonitis between Peritoneal Dialysis Solution TypesNephron Clinical Practice, 2007
- Fungal peritonitis at a tertiary care community teaching hospital: epidemiology, treatments, and outcome over a 3 year timespan*Mycoses, 2004
- Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis: a single centre Indian experienceJournal of Infection, 2004
- RENAL RESEARCH INSTITUTE SYMPOSIUM: Continuous Peritoneal Dialysis‐Associated Peritonitis: A Review and Current ConceptsSeminars in Dialysis, 2003
- Patterns of infection in patients maintained on long-term peritoneal dialysis therapy with multiple episodes of peritonitisAmerican Journal of Kidney Diseases, 2002
- Factors predicting outcome of fungal peritonitis in peritoneal dialysis: Analysis of a 9-year experience of fungal peritonitis in a single centerAmerican Journal of Kidney Diseases, 2000
- Fungal Peritonitis in Patients on Continuous Ambulatory Peritoneal DialysisEuropean Journal of Clinical Microbiology & Infectious Diseases, 1998
- Compliance in CAPD and CCPD patients as measured by supply inventories during home visitsAmerican Journal of Kidney Diseases, 1998
- Ten years experience of CAPD in diabetics: comparison of results with non-diabeticsNephrology Dialysis Transplantation, 1994