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TUBERCULOUS PERITONITIS IN CHRONIC RENAL FAILURE MANAGED BY CONTINUOUS AMBULATORY PERITONEAL DIALYSIS
Author(s) -
McKERROW K. J.,
NEALE T. J.
Publication year - 1983
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1983.tb04478.x
Subject(s) - medicine , continuous ambulatory peritoneal dialysis , peritonitis , peritoneal dialysis , hemodialysis , complication , surgery , chemoprophylaxis , tuberculosis , ambulatory , dialysis , intensive care medicine , pathology
Continuous ambulatory peritonea! dialysis (CAPD) is being increasingly used to treat chronic renal failure in New Zealand. Peritonitis due in particular to gram positive organisms remains the major complication. Three of 92 CAPD patients trained in the Wellington Renal Unit 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 leucocyte counts were not predictive of tuberculous infection and total leucocyte 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 anti‐tuberculous therapy, in all three patients. However, peritoneal pain on dialysis fluid in‐flow necessitated temporary hemodialysis management in two. Anti‐tuberculous chemoprophylaxis may be prudent in the at‐risk Polynesian patient with chronic renal failure who is being considered for CAPD management.