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.
Citation
Master of medicine,University of Nairobi,January,1985.Publisher
University of Nairobi medicine