Incidence of Peritonitis and Delayed-Type Hypersensitivity in Patients on CAPD

  • D. J. Tsakiris
  • T. C. Aitchison
  • J. D. Briggs
  • B. J. R. Junor
  • W. G. J. Smith
  • M. A. Watson


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.


Peritoneal Dialysis Strong Reactor Weak Reactor Chronic Peritoneal Dialysis Primary Renal Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Corey P: An approach to the statistical analysis of peritonitis data from patients on CAPD. Peritoneal Dial Bull 1: 529, 1981Google Scholar
  2. 2.
    MacGowen QP, Peterson PK, Keane W, and Quie PG: Human peritoneal macrophage phagocytic, killing and chemiluminescent responses to opsonised Listeria monocytogenes. Infect Immunol 40: 440, 1983Google Scholar
  3. 3.
    Verbugh HA, Keane WF, Hoidal JR, Freiberg MR, Elliot GR, and Peterson PK: Peritoneal macrophages and opsonins: Antibacterial defense in patients undergoing chronic peritoneal dialysis. J Infect Dis 147: 1018, 1983CrossRefGoogle Scholar
  4. 4.
    Rubin J, Lin LM, Lewis R, Cruse J, and Bower JD: Host defense mechanisms in CAPD. Clin Nephrol 20: 140, 1983PubMedGoogle Scholar
  5. 5.
    Diskin CJ, Coplon N, Feldman C, and Vosti K: Antimicrobial activity in CAPD. Peritoneal Dial Bull 3: 150, 1983Google Scholar
  6. 6.
    Christou NV, Meakins JL, and MacLean LD: The predictive role of delayed hypersensitiviy in preoperative patients. Surg Gynecol Obstet 152: 297, 1981PubMedGoogle Scholar
  7. 7.
    Bradley JA, Ledingham IMcA, and Hamilton DNH: Assessment of host resistance in critically ill surgical patients by the reponse to recall skin antigens. Intensive Care Med 7: 105, 1981PubMedCrossRefGoogle Scholar
  8. 8.
    Guttman RD, Meakins JL, Morehouse DD, and Milne C: Development of anergy to delayed-type hypersensitivity antigens following renal allotransplantation. Kidney Int 20: 275, 1981CrossRefGoogle Scholar
  9. 9.
    Milne CA, Guttman RD, and Meakins JL: Short-term implications of delayed-type hypersensitivity responses in renal transplant recipients. Transplant Proc 14: 673, 1982PubMedGoogle Scholar
  10. 10.
    Watson MA, Briggs JD, Diamandopoulos AA, Hamilton DNH, and Dick HM: Endogenous cell-mediated immunity, blood transfusion, and outcome of renal transplantation. Lancet 2: 1323, 1979PubMedCrossRefGoogle Scholar
  11. 11.
    Brown BW, Lagakos SW, and Byar DP: Statistical methodology. In Mike V, and Stanley K (Eds), Statistics in medical research. New York: John Wiley and Sons, 1982, p 317Google Scholar
  12. 12.
    Bendetti J, and Yuen K: Life tables and survival functions. In Dixon WJ, and Brown MB (Eds), BMDP-81, Bio-Medical computer programs, P-series, user’s manual. Los Angeles: University of California Press, 1981, p 557Google Scholar
  13. 13.
    Pierratos A, Amair P, Corey P, Vas SI, Khanna R, and Oreopoulos DG: Statistical analysis of the incidence of peritonitis on CAPD. Peritoneal Dial Bull 2: 32, 1982Google Scholar
  14. 14.
    Coward RA, Uttley L, Murray Y, Greenwood E, and Mallick NP: The importance of patient selection for CAPD. Peritoneal Dial Bull 2: 8, 1982Google Scholar
  15. 15.
    Vas S: Microbiological aspects of peritonitis. Peritoneal Dial Bull 1: S11, 1981Google Scholar
  16. 16.
    Slingeneyer A, Mion C, Beraud JJ, Oules R, Brauyer B, and Balmes M: Peritonitis, a frequently lethal complication of intermittent and continuous ambulatory peritoneal dialysis. Proc Eur Dial Transplant Assoc 18: 212, 1981PubMedGoogle Scholar
  17. 17.
    Plant J, and Glynn AA: Natural resistance to salmonella infection, delayed hypersensitivity and Ir genes in different inbred strains of mice. Nature 248: 345, 1974PubMedCrossRefGoogle Scholar
  18. 18.
    Magliulo E, DeFeo V, Stirpe A, Riva C, and Scevola D: Enhanced in vitro phagocytic power of macrophages from PPD-stimulated skin sites in human subjects hypersensitive to PPD. Clin Exp Immunol 14: 371, 1973PubMedGoogle Scholar
  19. 19.
    Lenzini L, Rottoli P, and Rottoli L: The spectrum of human tuberculosis. Clin Exp Immunol 27: 230, 1977PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • D. J. Tsakiris
    • 1
  • T. C. Aitchison
    • 1
  • J. D. Briggs
    • 1
  • B. J. R. Junor
    • 1
  • W. G. J. Smith
    • 1
  • M. A. Watson
    • 1
  1. 1.Renal Unit, Western Infirmary and the Department of StatisticsUniversity of GlasgowUSA

Personalised recommendations