Frequency, Microbiological and Clinical Analysis of Peritonitis Episodes in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis: A Five-Year Retrospective Single-Center Experience

Objective: This study aimed to assess the frequency, microbiological profile, and clinical outcomes of peritonitis in patients receiving Continuous Ambulatory Peritoneal Dialysis (CAPD). Methods: This retrospective, cross-sectional study included 52 adult PD patients followed at a tertiary hospital between January 2020 and December 2024. The diagnosis of peritonitis was based on cloudy dialysate, abdominal pain, fever, a dialysate leukocyte count >100 cells/mm³, and a polymorphonuclear cell ratio ≥50%. Microbiological culture results, laboratory findings, and clinical outcomes were analyzed. Results: Among the 52 CAPD patients included in the study, the mean age was 39.96 ± 17.91 years, with an equal gender distribution of 50% female and 50% male. The peritonitis rate was 34.6% (n=18), with 12 patients experiencing their first episode. All peritonitis cases were bacterial in origin, with two cases showing concomitant fungal coinfection. Microbiological cultures were positive in three patients, revealing Staphylococcus hemolyticus, coagulase-negative Staphylococcus, and Pseudomonas aeruginosa. The mean duration of peritoneal dialysis was 42.85 ± 25.97 months. Residual urine output was preserved in 65.4% (n=34) of patients. Diabetes mellitus was the most common cause of chronic kidney disease (38.5%), followed by hypertension (23.1%). Patients with peritonitis exhibited lower mean serum albumin (2.99 ± 0.90 g/L) and hemoglobin levels (9.75 ± 2.00 g/dL), while inflammatory markers procalcitonin (2.21 ± 3.41 μg/L) and ferritin (490.61 ± 473.26 μg/L) were elevated. The overall mortality rate was low at 3.8% (n=2), and 96.2% of patients (n=50) were discharged. Conclusion: Peritonitis occurred in 34.6% of patients undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD), predominantly of bacterial origin. Patients with peritonitis exhibited decreased serum albumin and hemoglobin levels, while inflammatory markers such as procalcitonin and ferritin were elevated. Although mortality was low, systemic effects related to infection were observed. These findings emphasize the importance of early diagnosis and infection control in CAPD patients.