Background: Peritoneal dialysis peritonitis remains a significant cause of morbidity for peritoneal dialysis patients and the main reason for conversion from peritoneal dialysis to hemodialysis. As the characteristics of patients and microbial susceptibility vary from center to center, the aim of this study is to evaluate the microbiology and the clinical outcomes among continuous ambulatory peritoneal dialysis patients in Kuching, Malaysia. Methods: This is a retrospective record review of 82 continuous ambulatory peritoneal dialysis patients who developed peritonitis during 2013 to 2015. Data examined included patients' demographic data, causative organisms, and outcomes. Results: A total of 124 episodes of peritonitis were recorded, and the overall peritonitis rate was 0.40 episodes per patient-year. There was an increasing incidence in continuous ambulatory peritoneal dialysis peritonitis over the 3-year study period (0.35 to 0.47 episodes per patient-year). The gram-negative peritonitis rate increased over the period until towards the end of the study period, when gram-positive and gram-negative organisms accounted for almost equal proportions of peritonitis. Streptococcus sp. was the most common organism among the gram-positive peritonitis while Pseudomonas sp. was the most common organism in gram-negative peritonitis. The culture-negative peritonitis rate was 25.8%. The peritoneal dialysis catheter was removed in 32 episodes (26.6%). The catheter loss rate was significantly higher in gram-negative peritonitis, as compared to gram-positive peritonitis (38.9 vs 16.7%, p = 0.027). Conclusions: The increasing trend of peritonitis and high rates of culture negativity and peritoneal dialysis catheter removal are areas that need further evaluation and improvement in the future. Study on risk factors of continuous ambulatory peritoneal dialysis peritonitis, detailed microbiology, and antimicrobial treatment and response are warranted to further improve the outcomes of continuous ambulatory peritoneal dialysis patients.
Case series Patients: Male, 39-year-old (age at diagnosis) • Male, 62-year-old (age at diagnosis) Final Diagnosis: Fabry disease Symptoms: Corneal verticillata • kidney failure • neuropathy • proteinuria Medication: — Clinical Procedure: — Specialty: Genetics • Hematology • Laboratory Diagnostics • Nephrology • Neurology • Ophthalmology Objective: Rare disease Background: No cases of Fabry disease (FD) have been reported thus far in Malaysia. We aimed to report the demographic characteristics, clinical manifestations, molecular results, and treatment outcomes of 2 FD cases. This study was a retrospective review of 2 family clusters of FD on follow-up in Sarawak, Malaysia. Case Reports: Two index patients were confirmed to have FD. Index patient 1, who had nephrotic-range proteinuria and cornea verticillata, carried a variant within exon 4 of the GLA gene: c.610 T>C (p.Trp204Arg). Agalsidase beta (Fabrazyme ® ) enzyme replacement therapy was initiated, with the absence of neutralizing antibody after 24 months. No hypersensitivity or adverse reactions were reported. The patient’s proteinuria and renal function remained stable. Other family members who carried the same mutation were asymptomatic. Index patient 2, who had residual activity of α-galactosidase A and a normal globotriaosylsphingosine level, carried a novel GLA mutation of c.548-5T>A. He was diagnosed with end-stage renal disease on regular dialysis and had nonspecific headache with 1 episode of seizure a few years prior to FD genetic screening. One brother had chronic neuropathic pain but refused further investigations. Other family members who had the same mutation were asymptomatic. This mutation has never been reported in literature, and its pathogenicity warrants further studies. Conclusions: It is of utmost importance to increase awareness of FD among clinicians, so that appropriate screening may be done to determine its true prevalence and prompt treatment can be initiated early.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.