PREVALENCIA DE PERITONITIS INFECCIOSA EN PACIENTES TRATADOS CON DIALISIS PERITONEAL INTERMITENTE MANUAL COMPARADA CON DIALISIS PERITONEAL INTERMITENTE AUTOMATICA DEL HGR. N. 1, IMSS, QUERETARO

Abstract

In patients with ESRD on renal replacement therapy of peritoneal dialysis, the main complication associated with this technique is infectious peritonitis and carries the risk of complications (fibrosis and peritoneal adhesions) that can compromise the effectiveness of peritoneal dialysis membrane , the main causative agents, Staphylococcus aureus and Staphylococcus epidermidis, gram-negative bacilli are responsible for one third of cases are seen less frequently in fungi, parasites and viruses, should be an empirical diagnosis of peritonitis if the dialysis fluid cloudy, leukocyte count greater than 100/mL in cytochemical and at least 50% of the leukocytes are neutrophils, and that clinical data are nonspecific, including nausea, vomiting, diarrhea hyporexia and diffuse abdominal pain with fever and should not But suspected in all patients and carrying out the protocol to confirm or discard. Prevalence of peritonitis during the eighties was more than one episode per patient per year, however, in this decade is less than that figure with significant differences from one country to another from one school to another and even from patient to patient . This decrease in the incidence of peritonitis is due to the improvement of the peritoneal access to the systems of systems disconnect "Y", washing prior to infusion and to a better understanding of the pathogenic mechanisms resulting in improved prophylaxis of peritonitis in national literature studies have reported an incidence of episodes per year of 0.41 to 1.71, with the presence of one episode every 19.3meses, a study conducted at the General Hospital of Mexico in the Internal Medicine 2006. Knowing the epidemiology of peritonitis in CAPD patients in our environment would be of great importance to try to contribute to better management of these patients and reduce their frequency, given the impact this can have on health CRF patients as well as economic implications involved in the treatment for both the patient and the institution, the literature reported 25 to 60% of transfers to hemodialysis.