CAPD Peritonitis Research Articles

Is CAPD Competitive with Haemodialysis for Long-term Treatment of Uraemic Patients?

Although there are only 10 years of clinical experience with CAPD, compared to about 30 years of clinical practice with haemodialysis, it is time to compare the results obtained from the two methods. In this review, after briefly summarising the state of the art for some worrisome aspects of CAPD (peritonitis, loss of ultrafiltration and peritoneal clearance, malnutritional status), the ability of CAPD and haemodialysis to control the uraemic abnormalities are compared. Anaemia, blood pressure, cardiac function, renal bone disease, beta 2-microglobulin, and uraemic neuropathy are examined in the light of our personal experience and the literature; data so far published seem to indicate that the two methods are roughly similar for controlling these conditions. A survey of the studies comparing patient and method survival is also included. Patient survival on CAPD or on haemodialysis does not differ by more than 6 years. Method survival is better for haemodialysis; this is primarily due to the high drop-out rate from CAPD because of peritonitis, and the difference is very much reduced in CAPD centres with a low incidence of peritonitis. On the whole, CAPD seems to be able to compete, sometimes favourably, with haemodialysis. However, in our opinion the two methods are not in competition; each has its preferential indications, limits and complications, and both should be offered to uraemic patients in accordance with their medical or social needs. One should be ready to shift the patient from one method to the other when necessary, either for short periods of time or indefinitely.

Treatment of CAPD Peritonitis with Oral Ciprofloxacin

Treatment of CAPD Peritonitis with Oral Ciprofloxacin

Intraperitoneal treatment of CAPD peritonitis with ciprofloxacin

Journal Article Intraperitoneal treatment of CAPD peritonitis with ciprofloxacin Get access H. LUDLAM, H. LUDLAM Departments of Microbiology and Renal Medicine. UMDS, St Thomas' HospitalLondon SE1 7EH, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar I. BARTON I. BARTON Departments of Microbiology and Renal Medicine. UMDS, St Thomas' HospitalLondon SE1 7EH, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar Journal of Antimicrobial Chemotherapy, Volume 24, Issue 4, October 1989, Pages 621–622, https://doi.org/10.1093/jac/24.4.621 Published: 01 October 1989

Stomatococcus mucilaginosus as an Agent of CAPD Peritonitis

We report a case of bacterial CAPD peritonitis in a 57 year old immunosuppressed woman with renal insufficiency caused by a rare species of the Micrococcaceae, Stomatococcus mucilaginosus. This uncommon case shows that the presence of gram-positive cocci in pairs, tetrads and clusters forming whitish-gummy colonies should remind us of the possibility of Stomatococcus mucilaginosus.

Surgical Peritonitis: Its Relevance to the Pathogenesis of Peritonitis in CAPD

Surgical Peritonitis: Its Relevance to the Pathogenesis of Peritonitis in CAPD

Staph. Epi. Peritonitis in CAPD

Staphylococcus epidermidis is frequently resistant to first‐generation cephalosporins. Although I have generally changed the therapy of S. epidermidis CAPD peritonitis to vancomycin when laboratory reports indicate cephalosporin resistance, it frequently appeared that improvement from the cephalosporin was taking place at the time of antibiotic conversion. Should the antibiotics be changed in this setting?

Diagnosis and Microbiological Monitoring of Peritonitis in CAPD: Considerations on their Clinical Value

Diagnosis and Microbiological Monitoring of Peritonitis in CAPD: Considerations on their Clinical Value

Book Review: Contributions to Nephrology. Volume 57: Peritonitis in CAPD

Book Review: Contributions to Nephrology. Volume 57: Peritonitis in CAPD

Is there an optimal methodology for the microbiological analysis of effluent in CAPD peritonitis?

The definition of CAPD peritonitis and reasons for negative effluent cultures are discussed. Based on published data, present-day recommendations for an optimal culture technique of CAPD effluents are given.

Isolation of organisms in CAPD peritonitis: use of nutrient broth cultures and Bactec blood culture media

Cultures of the first cloudy dialysates from 51 consecutive episodes of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis were carried out using concentrated nutrient broth and Bactec blood culture media in addition to primary culture on solid media. Thirtyseven episodes (73%) were positive on solid media, and 42 episodes (82%) were positive by both nutrient broth and Bactec methods. The value of Gram-stained smears and WBC counts on dialysates is discussed.

CAPD患者の細菌性腹膜炎に対するバンコマイシン (VCM) 療法

CAPDを施行中に急性腹膜炎を発症した男性5例, 女性2例の計7例にVCMの点滴静注または腹腔内注入を行い, その臨床的効果と安全性につき検討を行った.点滴静注はVCM 30mg/kgを1回1時間で点滴静注し, 静注後の血中濃度, CAPD液濃度を経時的に測定した. その結果, 1回投与で7日間にわたって, 10μg/ml以上の十分な有効血中濃度が得られることが判明した. CAPDにおけるVCMの腹膜よりのクリアランスは平均1.26ml/minで, 腹膜炎の治癒と共にそのクリアランスは低下傾向を認めた. またVCMの腹腔内投与はバッグ内へ初回のみ200mg, 以後100mgを注入, バッグの交換回数は2日目まで1日6回交換, 3日目より1日4回交換とし, 投与は10日間行った. 経時的にVCMの血中濃度, CAPD液濃度を測定し, 体内への吸収量を計算した. その結果, 腹腔内投与量の約70%が吸収され, 投与後24時間以内に有効血中濃度となった. また, 全例投与開始3日以内に腹膜炎症状は改善し, 5日以内に, 透析液細胞数は100/mm3以内となった.静脈内投与は5症例に7回施行したが, 副作用としては3症例の患者に軽度の筋肉痛・心悸亢進・掻痒感を認め投与中止した. 副作用の出現した3例の患者は腹腔内投与で治療を行った. 腹腔内投与例では明らかな副作用を認めなかった. 以上より, VCMの点滴静注および腹腔内投与はCAPDに併発するグラム陽性菌腹膜炎に対して有効かつ安全な療法であると思われた.

Vancomycin Tolerance in Staphylococcus Aureus Isolated during Treatment of CAPD Peritonitis

The susceptibility to vancomycin of nine staphylococcal strains responsible for nine episodes of peritonitis in patients on continuous ambulatory peritoneal dialysis was correlated with outcome of therapy. All strains examined had MIC values indicating sensitivity (MIC.:; 4 μg/ml). Tolerance was observed in one strain of Staphylococcus aureus (MIC = 1 μg/ml., MBC = 64 μg/ml). Time-kill studies using three different media demonstrated this organism's reduced susceptibility to vancomycin and suggested that testmedium composition may also affect the result. The patient with the tolerant strain, required an extended period of treatment.

V Isolation Rate (IR) of Organisms in CAPD Peritonitis Episodes (PE's): Use of Bactec and Nutrient Broth(NB)Cultures

<i>V</i> Isolation Rate (IR) of Organisms in CAPD Peritonitis Episodes (PE's): Use of Bactec and Nutrient Broth(NB)Cultures

ANTIFUNGAL TREATMENT OF CANDIDA PERITONITIS IN CAPD PATIENTS

ANTIFUNGAL TREATMENT OF CANDIDA PERITONITIS IN CAPD PATIENTS

Management of Peritonitis Complicating Continuous Ambulatory Peritoneal Dialysis: An Australian Perspective

In the decade following the introduction of CAPD by Popovich et al (I) substantial improvements have been made in the management of CAPD peritonitis. This review summarizes the significant advances in the prevention, diagnosis and treatment of CAPD peritonitis in the first 10 years of CAPD therapy (1976–1986) and highlights additional areas where management protocols can be improved further.

A Comparison of Intraperitoneal and Intravenous/Oral Antibiotics in CAPD Peritonitis

Eighty patients with CAPD peritonitis were randomised to receive either intraperitoneal (IP) vancomycin and tobramycin, or intravenous (IV) van-comycin and tobramycin followed by oral antibiotics, depending on the results of culture and sensitivity. Five patients were withdrawn, and, of the remaining patients, 39 were in the IP group and 36 in the IV group. When all episodes of bacterial peritonitis are considered, the treatment failure rate was higher in the IV group (34.1%), than in the IP group (10.3%) (p &lt; 0.02). This was also the case when gram-positive organisms resistant to tobramycin were considered separately (p &lt; 0.05), but not for vancoinycin-resistant organisms. We conclude that vancomycin should be administered by the intraperitoneal route: the case for intraperitoneal tobramycin is “not proven”.

Y-system with disinfectant in the prevention of peritonitis in CAPD.

Y-system with disinfectant in the prevention of peritonitis in CAPD.

Bacterial peritonitis in CAPD: pathogenesis, symptoms, therapy and progress.

Bacterial peritonitis in CAPD: pathogenesis, symptoms, therapy and progress.

Intraperitoneal immunoglobulin (IG) treatment in prophylaxis of bacterial peritonitis in CAPD.

To evaluate peritoneal immunological defences and to find a possible cure for alterations in the mechanism, we studied the capacity of peritoneal dialysis effluent (PDE) to opsonize bacteria and the phagocytic activity of peritoneal macrophages (PM). Subjects were 40 uremic patients followed for a mean period of 36 months and 40 normal women who underwent laparoscopy (Controls). Opsonic capacity for S.epidermidis of undiluted PDE from CAPD patients with low peritonitis occurrence (LPI) proved similar to that of 10% control serum. It was, however, noticeably inferior when patients were of high peritonitis incidence (HPI). In these cases IgG concentration in PDE was lower than in patients of LPI. A significant correlation was revealed between opsonization capacity for bacteria and IgG concentration values in PDE. We found inverse correlation between opsonic capacity of PDE and number of episodes of peritonitis. Phagocytic capacity of PM from CAPD patients was similar to that of control PM when microorganisms were preopsonized by control serum. Intraperitoneal Immunoglobulin treatment raised PDE opsonization capacity and lowered peritonitis incidence in patients of previously HPI, thus demonstrating the importance of abnormal organization in CAPD peritonitis and the possibility of preventing infections by intraperitoneal Immunoglobulin treatment. These prevention results do not occur with intravenous Immunoglobulin treatment.

Risk factors for peritonitis and technique failure in CAPD: increased age and dialysate IgG protect against peritonitis.

Risk factors for peritonitis and technique failure in CAPD: increased age and dialysate IgG protect against peritonitis.