A study of epidemiology and microbiology of peritonitis in continuous ambulatory peritoneal dialysis patients at Inkosi Albert Luthuli Central Hospital, Durban, South Africa.

Abstract

End Stage Renal Disease is a serious burden for both patients and health care professional mainly in the public service in South Africa. Haemodialysis is currently overstretched. All patients accepted in the state renal programme have to start with Continuous Ambulatory Peritoneal Dialysis (CAPD). Our study focused on patients treated by CAPD. One of the most common complications of CAPD is peritonitis. The files of 115 patients who attended the Renal Unit were reviewed and 91 met our inclusion criteria. This is a case control study where the cases were patients with peritonitis. Forty five patients developed peritonitis. The racial composition was: twenty four Indians (53. 3%), followed by the eighteen Africans (40%), the coloured and white group had two and one respectively, a total of three participants (6.7%). The study revealed that females were significantly more affected by peritonitis than males p=0.00466 There was no significant difference between Africans and Indians (p=0.2048). The study showed that among the co morbidities, only obesity and Diabetes Mellitus (DM) were significantly associated with the development of peritonitis. While bacterial peritonitis was the most prevalent at any stage, fungal peritonitis occurred only after one year. In conclusion this study highlights the spectrum of microbiology of peritonitis in CAPD patients. Furthermore the study showed there is a need to broaden the laboratory routine method screening for emerging microorganisms like Rhodotorula sp, a fungus isolated during our study, to reduce the percentage of culture negative peritonitis.