TUBERCULOUS PERITONITIS IN CHRONIC RENAL FAILURE MANAGED BY CONTINUOUS AMBULATORY PERITONEAL DIALYSIS

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Abstract
Three of 92 CAPD [continuous ambulatory peritoneal dialysis] patients trained in the Wellington Renal Unit [New Zealand] had tuberculous peritonitis, a previously rarely reported complication. Gram-positive or gram-negative bacterial infections preceeded or followed isolation of Mycobacterium tuberculosis. Differential peritoneal fluid leukocyte counts were not predictive of tuberculous infection; total leukocyte counts remained elevated in tuberculous patients treated for other concurrent bacterial peritonitides. Systemic toxicity was not encountered in these patients, symptoms being confined almost entirely to the peritoneum. CAPD was continued during treatment with antituberculous therapy in all 3 patients. Peritoneal pain on dialysis fluid in-flow necessitated temporary hemodialysis management in 2. Antituberculous chemoprophylaxis may be prudent in the at-risk Polynesian patient with chronic renal failure who is being considered for CAPD managment.

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