Incidence of Peritonitis and Delayed-Type Hypersensitivity in Patients on CAPD
Analysis of the incidence of peritonitis over a 3 year period was carried out, using techniques of survival data, in two groups of continuous ambulatory peritoneal dialysis (CAPD) patients who were separated on the basis of their cell-mediated immune response assessed by the skin reaction to dinitrochlorobenzene (DNCB). There were 28 weak and 23 strong DNCB reactors. Thirty-five percent of the first group remained free of peritonitis during the first 12 weeks of CAPD, compared to 75% of the latter group. Strong DNCB reactors also had a consistently higher probability of remaining free of peritonitis for longer before developing second and third episodes of peritonitis in comparison to the weak DNCB reactor group. Estimates of the mean times to the first, second and third episodes of peritonitis were 22, 43, and 70 weeks respectively for the weak DNCB group and 25, 84, and 109 weeks respectively for the strong reactor group. Although these differences between the groups failed to achieve statistical significance, there was a significant difference between the two groups in the number of patients requiring catheter removal following failure of antimicrobial therapy for bacterial peritonitis (67% vs 38%, p < 0.05). These results suggest that differences in the host immune response may influence susceptibility to peritonitis in CAPD patients.
KeywordsPeritoneal Dialysis Strong Reactor Weak Reactor Chronic Peritoneal Dialysis Primary Renal Disease
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