A Review of Peritonitis Episodes that Caused Interruption of CAPD

Abstract

In 49 of 508 ESRD patients, CAPD failed because of peritonitis, constituting the leading cause of such failure. These patients were divided into two groups (I and II) according to frequency of peritonitis. Group I patients (n = 25) had frequent, recurrent peritonitis (one episode every 2.6 months) whereas, among Group II patients, unusual or severe peritonitis (fecal, fungal and TB) was more common -in the latter the frequency of peritonitis was similar to that in the average population. Fecal peritonitis constituted 19% of all the episodes which led to interruption of CAPD; most of these cases seemed to be the result of diverticulitis. We believe that patients at particular risk of developing diverticulosis i.e., those older than 50 years and those with polycystic kidneys, should have a barium enema; if extensive diverticulosis is found, they should be considered to be at high risk for development of diverticulitis and fecal peritonitis. Even though the decreasing incidence of peritonitis leads to an overall decrease in peritonitis mortality and CAPD failure, once peritonitis develops, patients have the same risk of dying or failing now, as they had five years ago. For this reason we must undertake further studies in order to improve our management of these patients.