Idiopathic eosinophilic peritonitis in continuous ambulatory peritoneal dialysis: experience with percutaneous catheter placement.
BACKGROUND
Peritoneal fluid eosinophilia (PFE), which is classically associated with idiopathic eosinophilic peritonitis (EP), has been known as a common event in patients on continuous ambulatory peritoneal dialysis (CAPD). However, our recent retrospective study of CAPD patients following percutaneous catheter placement showed that PFE occurred rarely. The aim of this prospective study was to clarify the incidence and characteristics of idiopathic EP and PFE in patients on CAPD following percutaneous catheter placement.


METHODS
Forty-eight patients on CAPD following percutanous catheter placement were recruited for the present study. Peritoneal dialysis was initiated immediately after catheter insertion without break-in period. A cytological study of dialysate was performed on days 1, 2, 3, 4, 5, 6, 7, 14 and 30 after initiation of CAPD, and then monthly for 6 months. In addition, a cytological study was performed also when a patient revealed abdominal pain or cloudy peritoneal effluent.


RESULTS
PFE developed in three (6.3%) patients during the study period. The incidence of idiopathic EP and PFE without any clinical findings suggestive of PD-related peritonitis was 2.1% and 4.2% respectively. All cases of PFE, including idiopathic EP, developed on a mean of 13 day following initiation of CAPD and resolved spontaneously after a mean of 7 days. There was no significant difference in IgE levels or the occurrence of peripheral blood eosinophilia between patients with PFE and those without.


CONCLUSIONS
Idiopathic EP is infrequent among patients on CAPD following percutaneous catheter placement, but should be differentiated from infectious PD-related peritonitis.
Jo
Young-Il
YI
Division of Nephrology, Department of Internal Medicine, School of Medicine, Konkuk University, Seoul, Korea.
Song
Jong-Oh
JO
Park
Jung-Hwan
JH
Lee
Jong-Ho
JH
Shin
Sug Kyun
SK
D000328:Adult; D001202:Ascitic Fluid / Q000473:pathology; D002404:Catheterization; D004802:Eosinophilia / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology*; D011446:Prospective Studies; D012075:Remission, Spontaneous; D013997:Time Factors