Effluent microscopy is a useful adjuvant diagnostic tool in peritoneal dialysis-associated peritonitis.
Clin Nephrol
; 98(1): 33-41, 2022 Jul.
Article
in En
| MEDLINE
| ID: mdl-35393011
ABSTRACT
BACKGROUND:
Infectious complications are the leading cause of technical failure in peritoneal dialysis (PD); however, targeted anti-infective therapy is not feasible at the onset, as effluent cultures take days and may be inconclusive. Although recommended by the guidelines, divergent positivity rates of Gram-stained effluent microscopy question the value of its usefulness. This study aimed to evaluate if microscopy of cell types serves as an additional and timely diagnostic approach. MATERIALS ANDMETHODS:
This single-center retrospective analysis included prevalent PD patients (n = 250) between 2007 and 2017. Automated quantitative cell count, cytological analysis of Hemacolor and Gram-stained effluent sediment, and effluent cultures were conducted during peritonitis episodes. We calculated the rate of peritonitis, positivity rate of effluent cultures, and effluent microscopy.RESULTS:
There were 155 at-risk cases of peritonitis in 662.7 years during the observation period. The culture positivity rate was 73.5%. In neutrophilic culture-negative peritonitis (CNP), effluent Gram staining yielded the identification of the microbial species in 51.6% cases. In 24.4% of CNP, effluent microscopy showed eosinophilic peritonitis, which occurred with less initial effluent leucocytes and showed better PD survival.CONCLUSION:
In PD-associated peritonitis, Gram-stained dialysate with effluent microscopy supplements culture results in CNP. Hemacolor staining is crucial for differentiating eosinophilic peritonitis, showing a divergent clinical course and outcome.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Peritonitis
/
Peritoneal Dialysis
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Clin Nephrol
Year:
2022
Type:
Article