Idiopathic eosinophilic peritonitis in continuous ambulatory peritoneal dialysis: Experience with percutaneous catheter placement

Jo, Young-Il; Song, Jong Oh; Park, Jung Hwan; Lee, Jong‐Ho; Shin, Sug Kyun

doi:10.1111/j.1440-1797.2007.00794.x

Cited by 13 publications

(21 citation statements)

References 20 publications

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“…Eosinophilic peritonitis has most often been described in patients initiating PD: incidence 4% – 60% (with more recent studies pointing to a lower incidence since the 1990s) (5,6,10). In these cases, PD effluent cultures were negative and the pathogenesis was thought to be either an allergic reaction to a component of the PD system (catheter, solutions, sterilants, or plasticizers) or due to the introduction of air into the peritoneum (5-10). In the majority of these cases, the episodes were self-limited and of little consequence.…”

Section: Discussionmentioning

confidence: 99%

Vancomycin-Related Eosinophilic Peritonitis

Rosner

Chhatkuli

2009

Perit Dial Int

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Eosinophilic peritonitis (EP) is a well-described complication of peritoneal dialysis and is often associated with either a reaction to a constituent of the dialysis system (tubing, sterilant, or solution) or an underlying bacterial or fungal reaction. EP has also been described in the setting of icodextrin use. We report a case of EP associated with intraperitoneal vancomycin used in the treatment of peritonitis secondary to methicillin-resistant Staphylococcus epidermidis. Causation was based upon temporal association, negative cultures, concomitant peripheral eosinophilia, and resolution with cessation of vancomycin. Vancomycin allergy should be considered in the differential diagnosis of EP in the right clinical context. Negative bacterial and fungal cultures are essential to exclude other etiologies.

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Section: Discussionmentioning

confidence: 99%

Vancomycin-Related Eosinophilic Peritonitis

Rosner

Chhatkuli

2009

Perit Dial Int

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“…Identified risk factors associated with EP are exposure to vancomycin, infections (fungal or viral) after a recent catheter replacement or treatment with icodextrin, a polymer used to increase ultrafiltration in order to treat volume overload in ESRD [215,216]. More recent data from a prospective study of 48 patients undergoing CAPD suggested a smaller prevalence of PFE of less than 10% and shows no significant correlation between PBE and PFE [41]. PBE is typically detected in asymptomatic patients following catheter replacement and usually resolves spontaneously within a few days [41,213], although the course can be chronic or recurring with permanent changes in membrane function [217].…”

Section: Eosinophilia In Kidney Diseasementioning

confidence: 99%

“…More recent data from a prospective study of 48 patients undergoing CAPD suggested a smaller prevalence of PFE of less than 10% and shows no significant correlation between PBE and PFE [41]. PBE is typically detected in asymptomatic patients following catheter replacement and usually resolves spontaneously within a few days [41,213], although the course can be chronic or recurring with permanent changes in membrane function [217]. Considering the favorable prognosis, a steroid treatment in general is not recommended [214].…”

Section: Eosinophilia In Kidney Diseasementioning

confidence: 99%

Eosinophilia and Kidney Disease: More than Just an Incidental Finding?

Gauckler

Smıth

Mayer

et al. 2018

JCM

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Peripheral blood eosinophilia (PBE), defined as 500 eosinophils or above per microliter (µL) blood, is a condition that is not uncommon but often neglected in the management of patients with chronic kidney disease (CKD), acute kidney injury (AKI), or patients on renal replacement therapy (RRT). The nature of PBE in the context of kidney diseases is predominantly secondary or reactive and has to be distinguished from primary eosinophilic disorders. Nonetheless, the finding of persistent PBE can be a useful clue for the differential diagnosis of underdiagnosed entities and overlapping syndromes, such as eosinophilic granulomatosis with polyangiitis (EGPA), IgG4-related disease (IgG4-RD), acute interstitial nephritis (AIN), or the hypereosinophilic syndrome (HES). For patients on RRT, PBE may be an indicator for bio-incompatibility of the dialysis material, acute allograft rejection, or Strongyloides hyperinfection. In a subset of patients with EGPA, eosinophils might even be the driving force in disease pathogenesis. This improved understanding is already being used to facilitate novel therapeutic options. Mepolizumab has been licensed for the management of EGPA and is applied with the aim to abrogate the underlying immunologic process by blocking interleukin-5. The current article provides an overview of different renal pathologies that are associated with PBE. Further scientific effort is required to understand the exact role and function of eosinophils in these disorders which may pave the way to improved interdisciplinary management of such patients.

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“…PD is a treatment methodology that makes use of the semipermeable function of the peritoneum and is more biocompatible with body membranes. Thus, the elevation of EOC in PD patients is less common and milder than that in HD patients [12]. Accordingly, eosinophilia in PD patients is rare and not a common concern for clinicians and researchers.…”

Section: Introductionmentioning

confidence: 99%

Higher Eosinophils Predict Death-Censored Technique Failure in Peritoneal Dialysis Patients

Yang

Fan

et al. 2020

Int Arch Allergy Immunol

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Introduction: Eosinophilia (eosinophil fraction of leukocytes >5%), an indicative parameter for bioincompatibility in various circumstances, is well established in hemodialysis. However, change in eosinophil count (EOC) and its association with death-censored technique failure among peritoneal dialysis (PD) patients remain unclear. Methods: We compared eosinophils before and after PD initiation among 1,432 eligible continuous ambulatory PD patients regularly followed up in our PD center during 2007-2018. Risk factors of earlystage eosinophilia were examined by the logistic regression test. The relationship of early-stage eosinophilia and EOC with death-censored technique failure was examined using the Cox proportional hazards model for overall patients and for men and women separately. Results: After PD initiation, the EOC and percentage of patients with eosinophilia were significantly increased compared with baseline. Being male (odds ratio [OR]: 2.26; 95% confidence interval [CI]: 1.55-3.31; p < 0.001) and higher EOC at baseline (100 cells/μL increase, OR: 1.62; 95% CI: 1.45-1.82; p < 0.001) were risk factors of early-stage eosinophilia after PD initiation. During follow-up, 204 death-censored technique failures were recorded. In fully adjusted models, each with 100 cells/μL increase in EOC, the adjusted hazard ratios (HRs) of technique failure were 1.11 (95% CI: 1.03-1.20; p = 0.009) in the whole cohort, 1.29 (95% CI: 1.10-1.51; p = 0.002) in women, and 1.07 (95% CI: 0.97-1.17; p = 0.196) in men. Eosinophilia was significantly associated with the risk of technique failure for women (HR: 2.24; 95% CI: 1.07-4.70; p = 0.033), which was especially significant for women aged <55 years (HR: 7.61; 95% CI: 1.88-30.90; p = 0.005). Conclusion: EOC was increased significantly after PD initiation, and increased numbers of eosinophils were associated with higher death-censored technique failure in PD patients, especially women.

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Idiopathic eosinophilic peritonitis in continuous ambulatory peritoneal dialysis: Experience with percutaneous catheter placement

Abstract: Idiopathic EP is infrequent among patients on CAPD following percutaneous catheter placement, but should be differentiated from infectious PD-related peritonitis.

Cited by 13 publications

References 20 publications

Vancomycin-Related Eosinophilic Peritonitis

Vancomycin-Related Eosinophilic Peritonitis

Eosinophilia and Kidney Disease: More than Just an Incidental Finding?

Higher Eosinophils Predict Death-Censored Technique Failure in Peritoneal Dialysis Patients

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