Fungal peritonitis in peritoneal dialysis: a 10 year retrospective analysis in a single center

T. Basturk, Y. Koc, A. Unsal, E. Ahbap, T. Sakaci, I. Yildiz, H. Kayabasi, M. Sevinc, S. Kose, A. Arar

Department of Nephrology, Sisli Etfal Research and Education Hospital, Istanbul, Turkey. tanerbast@yahoo.com

 

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• Nephrology

INTRODUCTION: Fungal peritonitis (FP) is a rare but serious complication in patients undergoing peritoneal dialysis (PD), and is associated with higher morbidity, mortality. We aimed to analyze the predisposing factors, etiological agents, outcome and treatment of FP in patients with PD.

METHODOLOGY: We evaluated retrospectively all PD patients PD center between 2001 and 2011. Sixteen patients with FP were included into the study.

RESULTS: The clinical records of 16 patients with FP among 355 patients were reviewed for the clinical and laboratory data. Among 506 episodes of PD-related peritonitis in 10 years, we identified 16 episodes of FP. Median PD duration was 36.7±22.2 months. In 87.5% of patients had one or more previous episode of bacterial peritonitis that were treated with multipl broad-spectrum antibiotics. FP was primary infection in five patients, whereas eleven patients experienced FP during the course of treatment of bacterial peritonitis. Six patients died due to the fungal infection whereas others were transferred to haemodialysis.

CONCLUSIONS: Treatment of bacterial peritonitis with broad spectrum antibiotics was an important risk factor predisposing to the development of FP. The catheter removal and initiation of antifungal therapy as soon as possible are obligatory in episode of FP because it is responsible from high mortality rate.

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