Fungal peritonitis in peritoneal dialysis: an analysis of 21 cases.
OBJECTIVE
Fungal peritonitis is a rare but serious complication in patients undergoing peritoneal dialysis (PD). We aimed to analyze the predisposing factors, clinical aspects, etiological agents, and treatment of fungal peritonitis in patients with PD in our hospital.


METHODS
The data of all patients with PD, who were followed-up between January 1995 and December 2009, were evaluated retrospectively. Twenty-one patients with fungal peritonitis were included into the study.


RESULTS
Mean age was 46 ± 13. Twelve of the 21 patients were females. Median PD duration was 48 (range 9 to 95) months. Candida species were the most common pathogens isolated from peritoneal effluent fluid (n: 16): Candida albicans (14), Candida rugosa (n: 1), and Candida glabrata (n: 1). The other involved fungi were Aspergillus species (n: 1), Saccharomyces species (n: 1), Acromonium species (n: 1), Fusarium species (n: 1), and Rhodotorula mucilaginosa (n: 1). The PD catheter was removed in all of the patients. Median time until the PD catheter removal was 1 (range 0 to 10) day. Before 2005, this duration was 4 (0-10) days, whereas after 2005 it was 0 (0-2) days (P: 0.001). Therapy with amphotericin B and fluconazole was continued after catheter removal in 19 and in 2 of the patients, respectively. As a result of fungal peritonitis, 19 patients were transferred to hemodialysis. Two patients died during the episode of peritonitis.


CONCLUSIONS
Candida albicans was the most common pathogen. For the successful management of fungal peritonitis besides the antifungal therapy, peritoneal catheter removal was necessary in all of the patients.
Unal
Aydin
A
Department of Nephrology, Erciyes University Medical School, Kayseri, Turkey. aydinunal2003@gmail.com
Kocyigit
Ismail
I
Sipahioglu
Murat Hayri
MH
Tokgoz
Bulent
B
Oymak
Oktay
O
Utas
Cengiz
C
D000935:Antifungal Agents / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005658:Fungi / Q000302:isolation & purification*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
D000935:Antifungal Agents