PD Associated Recurrent Peritonitis

Abstract

If patient's immunity impairs due to the first episode of peritonitis, leads in some cases to another episode of peritonitis from a completely different organism, implying a different cause is known as Recurrent Peritonitis. Method: The study is based on the analysis of our data over a period of 16 years. The sample size was of 402 ESRD patients on CAPD. We retrospectively identified 20 cases of recurrent peritonitis, examined the demographic features, spectrum of pathogens and the outcome. Result: We analyzed 20 patients of recurrent peritonitis in which 11 (55%) patients developed aerobic peritonitis, 6 (30%) developed anaerobic peritonitis and 3 (15%) patients developed fungal peritonitis. We observed that all the three categories of recurrent peritonitis were predominantly found in the cases of diabetic nephropathy. Data were significant at 0.05 levels. When analysis was done between primary diagnosis and outcome, p value was 0.094 which was very near to significance; it might become significant if sample size would high. Aggressive combination therapy was given to the patients to avoid relapse and recurrent peritonitis. Outcome of anaerobic Recurrent Peritonitis is more dreaded than outcome of aerobic Recurrent Peritonitis. Worst outcome was observed when both the primary and Recurrent Peritonitis were due to fungal pathogens.Conclusion: The study illustrates that if, any symptom of peritonitis reappears after initial positive response within the fourth week of therapy of a prior episode, we should think of recurrent peritonitis. Hence, we should advice repeat counts and culture testing of dialysate, to avoid further recurrence and relapse.