Clinical and biochemical parameters associated with the removal of the peritoneal
catheter and death following
continuous ambulatory peritoneal dialysis (
CAPD)
peritonitis were analyzed in 120 episodes of
peritonitis. Episodes resulting in
catheter removal (n = 24, 20%) and those ending in patient death (n = 12, 10%) were respectively compared with episodes in which peritoneal
catheters were saved and from which the patients survived. Variables associated with
catheter removal included advanced age, long duration of
peritonitis, coexisting exit-site/tunnel
infection,
infection caused by pseudomonas or fungi, elevated
aspartate aminotransferase (AST) and
malnutrition at presentation with
peritonitis (
serum albumin 29.5 +/- 7.6 g/L vs 33.8 +/- 4.8 g/L in episodes in which the
catheters were saved, p = 0.014), and worsening
malnutrition during
peritonitis. Variables associated with death from
peritonitis included
diabetes mellitus, persistence of the
infection, removal of the peritoneal
catheter,
infection with pseudomonas,
malnutrition prior to the
infection (
serum albumin 29.5 +/- 3.2 g/L vs 34.7 +/- 4.2 g/L in survivors, p < 0.001), presentation with elevated AST and worsening
malnutrition, and the development of pronounced
malnutrition during
infection (
serum albumin 18.1 +/- 4.1 g/L vs 28.9 +/- 5.8 g/L in survivors, p < 0.001). Deaths were caused primarily by cardiovascular events. Both removal of the peritoneal
catheter and death as consequences of
CAPD peritonitis are associated with
malnutrition and
pseudomonas infection. In addition, death is more frequent in diabetic patients.