Home About us Current issue Back issues Submission Instructions Advertise Contact Login   

Search Article 
  
Advanced search 
 
Saudi Journal of Kidney Diseases and Transplantation
Users online: 1316 Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size 

ORIGINAL ARTICLE Table of Contents   
Year : 2012  |  Volume : 23  |  Issue : 1  |  Page : 44-47
Tuberculous peritonitis associated with peritoneal dialysis


1 Department of Internal Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
2 Department of Nephrology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia

Correspondence Address:
Abdelkarim Waness
SKMC - Research Center Director, Consultant, Department of Internal Medicine, Sheikh Khalifa Medical City, P.O. Box 51900, Abu Dhabi
United Arab Emirates
Login to access the Email id


PMID: 22237217

Rights and Permissions

Even though rare, tuberculous peritonitis (TBP) in patients on continuous ambulatory peritoneal dialysis (CAPD) is a perilous condition. Physicians worry about continuing treatment of their patients, whether to continue this modality of dialysis or switch to hemodialysis. A retrospective cohort study of 89 patients undergoing CAPD over a 12-year period was carried out for any episode of peritonitis with the objectives to find out the incidence of TBP in these patients, evaluation of patients' 3-year survival, possibility of retention of Tenckhoff catheter, and modality of dialysis post-infection. One hundred and three episodes of peritonitis occurred in our patients. Most of them were bacterial and occasionally fungal. We identified four cases of TBP, with one patient having concurrent bacterial infection in the peritoneal fluid. The clinical presentation was insidious with cloudy fluid in all cases. The diagnosis was established by the polymerase chain reaction (PCR) technique in one case, by positive peritoneal fluid culture for Mycobacterium tuberculosis in two cases, and clinically in the fourth one that responded well to anti-tuberculous therapy. All four patients survived their mycobacterial infection. Removal of catheter was necessary in all four patients and all were converted to hemodialysis. Three patients remained on hemodialysis thereafter, and one patient had to be re-implanted with a new catheter and was restarted on CAPD. TBP in patients undergoing CAPD in Jeddah remains a real concern, especially with the evidence of high prevalence of tuberculosis and with the emergence of drug-resistant tuberculosis. We recommend early initiation of anti-tuberculous therapy and removal of the Tenckhoff catheter for better survival. Most of these patients probably will require conversion to hemodialysis, but in a selected few CAPD can be restarted.


[FULL TEXT] [PDF]*
Print this article  Email this article
    

  Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
   Citation Manager
  Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed3168    
    Printed82    
    Emailed0    
    PDF Downloaded773    
    Comments [Add]    
    Cited by others 1    

Recommend this journal