PERITONEAL DIALYSIS-ASSOCIATED FUNGAL PERITONITIS: A RETROSPECTIVE ANALYSIS IN A SINGLE CENTER

Background: Fungal peritonitis (FP) is a kind of serious complications in end-stage renal disease (ESRD) patients who receiving peritoneal dialysis (PD), and has a high mortality rate. The present study aimed to analyze the predisposing factors, etiological agents, outcome and treatment of fungi causing peritonitis in patients with PD.

Methods: We evaluated retrospectively the series of 16 patients of FP were included from the PD peritonitis database in Shenzhen people’s hospital PD center between 2005 and 2015.

Results: The clinical and laboratory records of 16 patients with FP among episodes of PD-related peritonitis were reviewed. All patient had type 2 diabetes mellitus. FP was primary infection in 5 patients, whereas 11 patients experienced FP during the course of treatment of bacterial peritonitis, which were treated with antibiotics. No patient avoided catheter removal and 12 patients were transferred to hemodialysis. Of the 16 cases, 4 patients died as a result of the fungal infection. Most (9 of 16) were saprophytic; only 7 were normal skin flora. In 9 patients, the infection occurred in the wet season (May - September). In line with the standard of clinical diagnosis of peritonitis.

Discussion and Conclusions: The FP cases described in this series are particularly predisposed to infection with the exotic fungi as a result of environmental and social factors involved. Nevertheless, significant seasonal variations were observed in the rates of peritonitis due to specific microorganisms. The catheter removal and initiation of antifungal therapy as soon as possible in FP is necessary, because it is responsible for the high mortality rate. Although there are limited data for support, further understanding may help reduce the risk of fungal peritonitis.