Tuberculous peritonitis in patients on peritoneal dialysis: a 35-year experience from a large medical center in Northern Taiwan

Tuberculous peritonitis (TBP) is a rare but fatal complication in patients on peritoneal dialysis (PD). In this study, we aimed to determine the demographic features, clinical features, laboratory parameters, and clinical outcomes of PD patients with TBP and to clarify possible risk factors for mort...

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Bibliographic Details
Published in:Renal failure 2023-12, Vol.45 (1), p.2153064-2153064
Main Authors: Yang, Tzu-Yi, Tian, Ya-Chung, Yen, Tzung-Hai, Chang, Ming-Yang, Lin, Chan-Yu, Liu, Shou-Hsuan
Format: Article
Language:English
Subjects:
catheter removal
Catheters
Cell culture
Clinical Study
Diabetes mellitus
Diagnosis
Effluents
Fever
Hemodialysis
Humans
Leukocytes (neutrophilic)
Mortality
Patients
Peritoneal dialysis
Peritoneal Dialysis - adverse effects
Peritoneal fluid
Peritoneum
Peritonitis
Peritonitis - etiology
Peritonitis - microbiology
Peritonitis, Tuberculous - diagnosis
Peritonitis, Tuberculous - epidemiology
Peritonitis, Tuberculous - etiology
Retrospective Studies
Risk factors
Taiwan - epidemiology
Tuberculosis
tuberculous peritonitis
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Summary:Tuberculous peritonitis (TBP) is a rare but fatal complication in patients on peritoneal dialysis (PD). In this study, we aimed to determine the demographic features, clinical features, laboratory parameters, and clinical outcomes of PD patients with TBP and to clarify possible risk factors for mortality. We retrospectively reviewed 2084 PD patients from January 1985 to December 2019. The diagnosis of TBP was established by positive peritoneal fluid culture for Mycobacterium tuberculosis. 18 patients were diagnosed with TBP. The incidence was 2.029 episodes per 1000 patient-years. The most common symptom was fever (94.4%), followed by cloudy effluent (83.3%) and abdominal pain (83.3%). The average peritoneal dialysis effluent (PDE) white blood cell (WBC) count was 172.7 cells/μL. Nine patients (50%) had WBC counts lower than 100 cells/μL and 13 patients (72.2%) had neutrophilic predominant WBC counts. Acid fast stain (AFS) was positive in 7 patients (38.9%). Only 2 patients (11.1%) continued with PD after TB infection, while 10 patients (55.6%) changed to hemodialysis. Seven patients (38.9%) died within 1 year. Significant differences were observed in sex (p = 0.040), the presence of diabetes mellitus (p = 0.024), and PD catheter removal (p 
ISSN:0886-022X
1525-6049
DOI:10.1080/0886022X.2022.2153064