Presence of SARS-CoV-2 Antibodies in Spent Peritoneal Dialysate

A patient with end-stage renal disease on CAPD, and with massive iron overload is reported. This patient had evidence of myocardial and hepatic damage probably as a result of iron overload. Treatment with desferoxamine resulted in removal of iron in the peritoneal dialysate. On the basis of preliminary studies in this patient it would appear that removal of iron by peritoneal dialysis in conjunction with chelation therapy is safe and effective. This finding should have wide-ranging signficance for patients with ESRD.

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Cefoperazone and sulbactam-related eosinophilic peritonitis: a case report and literature review

Journal of International Medical Research ◽

10.1177/03000605211025367 ◽

2021 ◽

Vol 49 (6) ◽

pp. 030006052110253

Author(s):

Zi Wang ◽

Zhiying Li ◽

Suping Luo ◽

Zhikai Yang ◽

Ying Xing ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Blood Cells ◽

White Blood Cells ◽

Antibiotic Use ◽

Absolute Count ◽

Peritoneal Dialysate ◽

Refractory Peritonitis ◽

Technique Failure ◽

Peritoneal Dialysis Effluent ◽

Pathogenic Infection

Eosinophilic peritonitis (EP) is a well-described complication of peritoneal dialysis that occurs because of an overreaction to constituents that are related to the catheter or tubing, peritoneal dialysate, pathogenic infection, or intraperitoneal drug use. EP caused by antibiotic use is rare. We present the case of a patient with cefoperazone and sulbactam-related EP. A 59-year-old woman who was undergoing peritoneal dialysis presented with peritonitis with abdominal pain and turbid peritoneal dialysis. Empiric intraperitoneal cefazolin in combination with cefoperazone and sulbactam was started after peritoneal dialysis effluent cultures were performed. Her peritonitis achieved remission in 2 days with the help of cephalosporin, but she developed EP 1 week later, when her dialysate eosinophil count peaked at 49% of the total dialysate white blood cells (absolute count, 110/mm3). We excluded other possible causes and speculated that cefoperazone and sulbactam was the probable cause of EP. The patient continued treatment with cefoperazone and sulbactam for 14 days. EP resolved within 48 hours after stopping cefoperazone and sulbactam. Thus, EP can be caused by cefoperazone and sulbactam use. Physicians should be able to distinguish antibiotic-related EP from refractory peritonitis to avoid technique failure.

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The Iron Biology Status of Peritoneal Dialysis Patients May be a Risk Factor for Development of Infectious Peritonitis

Peritoneal Dialysis International ◽

10.3747/pdi.2018.00052 ◽

2019 ◽

Vol 39 (4) ◽

pp. 362-374 ◽

Cited By ~ 1

Author(s):

Marwh Aldriwesh ◽

Noura Al-Dayan ◽

Jonathan Barratt ◽

Primrose Freestone

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Peritoneal Dialysis ◽

Stress Hormones ◽

Infection Risk ◽

Mortality And Morbidity ◽

Peritoneal Dialysate ◽

Susceptibility To Infection ◽

Infection Risk Factors

Background Infectious peritonitis is a clinically important condition contributing to the significant mortality and morbidity rates observed in peritoneal dialysis (PD) patients. Although some of the socioeconomic risk factors for PD-associated peritonitis have been identified, it is still unclear why certain patients are more susceptible than others to infection. Methods We examined the molecular components of human peritoneal dialysate (HPD) in an attempt to identify factors that might increase patient susceptibility to infection. Characterization studies were performed on initial and follow-up dialysate samples collected from 9 renal failure patients on PD. Results Our in vitro data showed that peritonitis-causing bacteria grew differently in the patient dialysates. Proteomic analysis identified an association between transferrin presence and infection risk, as peritoneal transferrin was discovered to be iron-saturated, which was in marked contrast to transferrin in blood. Further, use of radioactive iron-labeled transferrin showed peritoneal transferrin could act as a direct iron source for the growth of peritonitis-causing bacteria. We also found catecholamine stress hormones noradrenaline and adrenaline were present in the dialysates and were apparently involved in enhancing the growth of the bacteria via transferrin iron provision. This suggests the iron biology status of the PD patient may be a risk factor for development of infectious peritonitis Conclusions Collectively, our study suggests transferrin and catecholamines within peritoneal dialysate may be indicators of the potential for bacterial growth in HPD and, as infection risk factors, represent possible future targets for therapeutic manipulation.

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