Predictors and outcomes of fungal peritonitis in peritoneal dialysis patients

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dc.contributor.authorMiles, R.
dc.contributor.authorHawley, C.
dc.contributor.authorMcDonald, S.
dc.contributor.authorBrown, F.
dc.contributor.authorRosman, J.
dc.contributor.authorWiggins, K.
dc.contributor.authorBannister, K.
dc.contributor.authorJohnson, D.
dc.date.issued2009
dc.description.abstractFungal peritonitis is a serious complication of peritoneal dialysis but previous reports on this have been limited to small, single-center studies. Using all Australian peritoneal dialysis patients, we measured predictors, treatments, and outcomes of this condition by logistic regression and multilevel, multivariate Poisson regression. This encompassed 66 centers over a 4-year period that included 162 episodes of fungal peritonitis (4.5% of all peritonitis episodes) that occurred in 158 individuals. Candida albicans (25%) and other Candida species (44%) were the most common fungi isolated. Fungal peritonitis was independently predicted by indigenous race and prior treatment of bacterial peritonitis. Peritonitis episodes occurring after 7 and 60 days of treatment for previous bacterial peritonitis decreases in the probability of fungal peritonitis 23 and 6%, respectively. Compared with other organisms, fungal peritonitis was associated with significantly higher rates of hospitalization, catheter removal, transfer to permanent hemodialysis, and death. The risks of repeat fungal peritonitis and death were lowest with catheter removal combined with antifungal therapy when compared to either intervention alone. Our study shows that fungal peritonitis is a serious complication of peritoneal dialysis and should be strongly suspected in the context of recent antibiotic treatment for bacterial peritonitis.
dc.description.statementofresponsibilityRhianna Miles, Carmel M. Hawley, Stephen P. McDonald, Fiona G. Brown, Johan B. Rosman, Kathryn J. Wiggins, Kym M. Bannister and David W. Johnson
dc.identifier.citationKidney International, 2009; 76(6):622-628
dc.identifier.doi10.1038/ki.2009.202
dc.identifier.issn0085-2538
dc.identifier.issn1523-1755
dc.identifier.orcidMcDonald, S. [0000-0001-6103-1386]
dc.identifier.urihttp://hdl.handle.net/2440/57384
dc.language.isoen
dc.publisherBlackwell Publishing Inc
dc.source.urihttps://doi.org/10.1038/ki.2009.202
dc.subjectantifungal agents
dc.subjectCandida
dc.subjectfungus
dc.subjectoutcomes
dc.subjectperitonitis
dc.subjectyeast
dc.titlePredictors and outcomes of fungal peritonitis in peritoneal dialysis patients
dc.typeJournal article
pubs.publication-statusPublished

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