Peritonitis in patients undergoing peritoneal-dialysis Kenyatta National Hospital Nairobi Kenya

Abstract

This study was undertaken between January 1980 and September 1984 and was to try to map out the incidence of peritonitis in patients undergoing peritoneal dialysis at Kenyatta National Hospital and to see how best to manage this crippling complication of peritoneal dialysis. A total of 192 patients were studied in two groups namely a retrospective grol1p 1980-1982 and a prospective group 1983 to September 1984. Out of 192 patients admitted to Intensive Care Unit (I.C.U.) for dialysis, 108 had peritoneal dialysis, 4 did not get dialysed as they improved on conservative management and 3 died soon after admission to I.C.U. 77 Patients had haemodialysis. 53.7% of the patients undergoing peritoneal dialysis (PD) suffered from peritonitis and Klebsiella was the .commonest causative organism accounting for 54.8%. This certainly is surprising as literature from the industrialized countries reveals that gram negative organisms comprise only 25% whilst gram positive organisms comprise 68.5% of peritonitis. Peritonitis developing during peritoneal dialysis is best managed ·conservatively by appropriate antibiotics and this study revealed that the infection cleared by about the seventh day. It also became quite clear that peritonitis caused prolonged hospital stay thus increasing the cost, the morbidity and to some extent the mortality of the patients involved.