Peritonitis during Continuous Ambulatory Peritoneal Dialysis (CAPD): Risk Factors, Clinical Severity, and Pathogenetic Aspects

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Abstract
This study of 228 episodes of peritonitis occurring during a total observation time of 2365 treatment months over a six-year period in a uniformly selected, trained, and treated continuous ambulatory peritoneal dialysis (CAPD) population (N = 124) showed the following major findings: 1) the risk of developing peritonitis was 55% within the first year and 89% within the first three years on CAPD; 2) high age (≥60 years) and year of CAPD start were risk factors for peritonitis; 3) neither sex, diabetes, or hypoalbuminemia were found to be risk factors for peritonitis; 4) the year of start, but neither the degree of severity, nor the time of the first episode affected the risk of developing a second episode of peritonitis; 5) no specific characteristics were identified in patients with the highest mean peritonitis incidence or in the patients without peritonitis; 6) in 27% of all episodes, turbidity of the dialysate was the only clinical finding; 7) the proportion of asymptomatic episodes was lower in patients ≥ 60 years; 8) the degree of clinical severity of peritonitis was not statistically influenced by the number of previous episodes; 9) the cause of peritonitis was established in only 26% of all cases; and 10) no statistical association was found between the cause of peritonitis and patient characteristics.