Use of biologically synthesized antimicrobial nanoparticles for improving peritoneal dialysis technique: a translational research perspective.

Abstract

Peritoneal dialysis (PD) is a well-established renal replacement therapy (RRT) for end-stage renal failure (ESRF)[1] and offers certain clear advantages over hemodialysis[2]. However, PD is often associated with a high risk of infection of the intraperitoneal cavity, subcutaneous tunnel and catheter exit site, which may subsequently form microbial biofilms[1]. Generally, a majority of PD patients suffer from bacterial and fungal infections and if the infection(s) is diagnosed timely, they can be resolved by appropriate antibiotic treatment. However, the immune system of ESRF patients continuing on PD may have been compromised and infections are as frequent as once every 10-15 weeks necessitating frequent use of conventional antimicrobial drugs, which may cause emergence of drug resistance. Further as, higher doses of antibiotics are often required for such infections, this may cause intolerable toxicity. Moreover, infections, if correct it as “not resolve and sustain” for a week or more, may lead to infectious peritonitis[1], which severely affects the functioning of the peritoneal membrane, and its resolution may require hospitalization of the patient.