An eight-year retrospective study was performed to determine the incidence of
peritonitis in a pediatric
continuous ambulatory peritoneal dialysis (
CAPD) population of 24 children, half of whom were boys and half, girls. All suffered from
end stage renal disease (
ESRD). When these children, aged 2 through 17 years (mean: 10.7 +/- 3.8), were examined, the incidence of
peritonitis was one episode every 15.2 patient-months. Microbiologic evaluation showed that 76.4% of the 34 episodes were culture positive, with Staphylococci species (
coagulase negative staphylococci 32.4%, Staphylococcus aureus 14.7%) causing most cases especially early in dialysis. Half the patients presented with a triad of symptoms (
fever,
abdominal pain and cloudy
dialysate), with cloudy
dialysate was the major presentation (88%).
Peritonitis was treated with intraperitoneal administration of cefacin and/or
netromycin when suspected, and 52.9% of the episodes needed hospitalization. Except for two patients who died of complications (
sepsis,
acute pancreatitis), all episodes of
peritonitis were cured; in four episodes it was necessary to remove a
catheter, and two of those cases came from fungal
peritonitis.
Peritonitis rates differed among disconnect systems. The manual spike had
peritonitis rate of one episode per 4.6 patient-months which was higher than the O-set (one episode/22.2 patient-months), UV-XD and Y-set disconnect systems. Therefore, the major causes of
peritonitis arose from contamination provoked by the technical aspect of the procedure. Nutrition status was stable in these patients.
Serum albumin and total
protein were adequate in all patients without relation to episode of
peritonitis.(ABSTRACT TRUNCATED AT 250 WORDS)