The infectious complications and the causes in continuous ambulatory peritoneal dialysis patients; a retrospective study

Continuous Ambulatory Peritoneal Dialysis (CAPD) is used as renalreplacement therapy for end stage renal failure patients more frequently at last years.Infectious complications ( tunnel and exit site infection and peritonitis) can be seen atsignificant number of the patients. Unfortunately too many patients leaves CAPDprogram because of peritonitis.Sixty-five end stage renal failure patients who were end stage renal failure withCAPD and CAPD catheter insertion were made at the Cukurova University Faculty ofMedicine Hospital between January 2003 and January 2006 were enrolled into thisstudy. All of the patients characteristics such as age, sex, accompanied disease, theetiology of the chronic renal failure, if there was any history of hemodialysis andtransplantation, the reason for choosing CAPD, the peritoneal catheter insertiontechniques and frequency of infectious complication was recorded. The patients whohad peritonitis attack was examined for signs and symptoms before peritonitis, thetime of these sign and symptoms, the time between insertion of peritoneal catheter andperitonitis, cell number in peritoneal fluid at the diagnosis of peritonitis and cultureresults. All of the patient?s blood counts and some biochemical parameters were notedbasally. Differences between patients who had peritonitis attack or not were analyzedand recorded.Infectious complication developed at the 24 patients out of 65 patients. Twopatients had tunnel infection, two patients had tunnel infection with peritonitis andother 20 patients had only peritonitis. The peritonitis incidence was found 0.329 attackper year or one attack at 36.4 month. The most frequent microorganism at the cultureswas coagulase negative staphylococcus. Statistically higher incidence of infectiouscomplication rate was found at the patients whom catheter were inserted with surgically(p=0.045) and (p=0.04). The patients with peritonitis had statistically lower basal serumalbumin level(p=0.02) and basal BUN level (p=0.013).At the result our study suggested that lower albumin and BUN level as aindicator of malnutrition were a risk factor for development of peritonitis. Howeverincreasing incidence of peritonitis at surgically placed CAPD catheter and CAPDinserted because of no intravenous line can be found for hemodialysis can be found asanother predisposing factor for development of peritonitis.Keywords: Albumin, Peritonitis, CAPD