Epidemiology of Culture-Negative Peritonitis in Iranian Patients on Continuous Ambulatory Peritoneal Dialysis

Authors

  • Iraj Najafi Division of Nephrology, Department of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Shahrzad Ossareh Division of Nephrology, Department of Medicine, Hasheminejad Clinical Research Development Center, Tehran University of Medical Sciences, Tehran, Iran
  • Mostafa Hosseini Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  • Mohammad Reza Ganji Division of Nephrology, Department of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Massih Naghibi Division of Nephrology, Department of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
  • Khadijeh Makhdoomi Division of Nephrology, Department of Medicine, Imam Khomeini Hospital, Urmiah University of Medical Sciences, Urmiah, Iran
  • Mohammad Reza Ardalan Division of Nephrology, Department of Medicine, Imam Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
  • Nader Nouri-Majalan Division of Nephrology, Department of Medicine, Sadoughi Hospital, Yazd University of Medical Sciences, Yazd, Iran
  • Jalal Azmandian Division of Nephrology, Department of Medicine, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
  • Houshang Sanadgol Division of Nephrology, Department of Medicine, Ali-ebn Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
  • Shiva Seirafian Division of Nephrology, Department of Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  • Shahnaz Atabak Division of Nephrology, Department of Medicine, Modares Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Introduction. Culture-negative peritonitis is a major challenge in the treatment of peritonitis in continuous ambulatory peritoneal dialysis (CAPD). This study aimed to evaluate the culture-negative peritonitis in patients from the Iranian CAPD Registry.

Materials and Methods. Data of 1472 patients from 26 CAPD centers were analysed. Peritonitis was defined as any clinical suspicion together with peritoneal leukocyte count of 100/mL and more.

Results. The patients had been on PD for a mean of 500 ± 402 days. There were a total of 660 episodes of peritonitis observed among 299 patients (peritonitis rate of 1 episode in 34.1 patient-months). Excluding patients with both negative and positive culture results, there were 391 episodes of peritonitis in 220 patients (174 culture-positive episodes in 97 patients and 217 culture-negative episodes in 123). The 1- to 4-year patient survival rates were 85%, 75%, 69%, and 59% for the patients with culture-positive peritonitis, and 92%, 78%, 73% and 63% for the patients with culture-negative peritonitis, respectively (P = .34). The technique survival rates were 90%, 57%, 42%, and 27% and 95%, 85%, 74%, and 40%, respectively (P = .001). On follow-up, there were higher rates of active PD patients, lower rates of PD dropouts, and higher rates of kidney transplantation in patients with culture-negative peritonitis compared to those with culture-positive peritonitis.  

Conclusions. In our patients, the prevalence of culture-negative peritonitis was high (55.9%). Patient survival with culture-negative peritonitis was comparable to those with culture-positive peritonitis and technique survival was higher among those with culture-negative peritonitis.

Author Biographies

  • Iraj Najafi, Division of Nephrology, Department of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
    Associate Professor of Medicine, Department of Medicine, Nephrology division, Shariati Hospital, Tehran University of Medical Sciences

     

  • Shahrzad Ossareh, Division of Nephrology, Department of Medicine, Hasheminejad Clinical Research Development Center, Tehran University of Medical Sciences, Tehran, Iran
    Associate Professor of Medicine, Department of Medicine, Nephrology division, Hasheminejad Kidney Centre, Tehran University of Medical Sciences
  • Mostafa Hosseini, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Associate Professor of Biostatistics, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences.

  • Mohammad Reza Ganji, Division of Nephrology, Department of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
    Associate Professor of Medicine, Department of Medicine, Nephrology division, Shariati Hospital, Tehran University of Medical Sciences.
  • Massih Naghibi, Division of Nephrology, Department of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
    Associate Professor of Medicine, Department of Medicine, Nephrology division, Imam Reza Hospital, Mashad University of Medical Sciences
  • Khadijeh Makhdoomi, Division of Nephrology, Department of Medicine, Imam Khomeini Hospital, Urmiah University of Medical Sciences, Urmiah, Iran
    Associate Professor of Medicine, Department of Medicine, Nephrology division, Imam Khomeini Hospital, Urmiah University of Medical Sciences
  • Mohammad Reza Ardalan, Division of Nephrology, Department of Medicine, Imam Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
    Associate Professor of Medicine, Department of Medicine, Nephrology division,  Imam Hospital, Tabriz University of Medical Sciences
  • Nader Nouri-Majalan, Division of Nephrology, Department of Medicine, Sadoughi Hospital, Yazd University of Medical Sciences, Yazd, Iran
    Assistant Professor of Medicine, Department of Medicine, Nephrology division, Sadoughi Hospital, Yazd University of Medical Sciences
  • Jalal Azmandian, Division of Nephrology, Department of Medicine, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
    Associate Professor of Medicine, Department of Medicine, Nephrology division, Shafa Hospital, Kerman University of Medical Sciences
  • Houshang Sanadgol, Division of Nephrology, Department of Medicine, Ali-ebn Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran

    Associate Professor of Medicine, Department of Medicine, Nephrology division, Ali-ebn Abitaleb Hospital, Zahedan University of Medical Sciences

  • Shiva Seirafian, Division of Nephrology, Department of Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
    Assistant Professor of Medicine, Department of Medicine, Nephrology division, Alzahra Hospital, Esfahan University of Medical Sciences
  • Shahnaz Atabak, Division of Nephrology, Department of Medicine, Modares Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    Associate Professor of Medicine, Department of Medicine, Nephrology division, Modares Hospital, Shahid beheshti University of Medical Sciences

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Published

2011-08-29

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Section

ORIGINAL | Dialysis