The value of low-dose intraperitoneal immunoglobulin administration in the treatment of peritoneal dialysis-related peritonitis

J Nephrol. 2004 May-Jun;17(3):427-30.

Abstract

Background: Peritonitis is a major complication of continuous ambulatory peritoneal dialysis (CAPD). The value of immunomodulatory therapeutic approaches and, especially, methods aimed at augmenting opsonization in the treatment of peritoneal dialysis (PD)-related peritonitis is unclear. In this study, the effect of intraperitoneal (IP) immunoglobulin (Ig) usage, as an approach for strengthening opsonization, was evaluated in CAPD peritonitis.

Methods: The study included 24 patients with CAPD peritonitis. The patients were divided into two groups, A and B, each consisting of 12 patients. There were no significant differences between the groups in terms of age, gender, CAPD duration, and peritonitis rate. Empiric antibiotic treatment was a 2-week IP ampicillin+sulbactam/netilmycin combination. Group B was additionally given low-dose IP IgG (2 mL = 320 mg) with every exchange. The dialysate leucocyte counts were obtained in both groups until the number was <100 cells/microL to monitor the response to peritonitis treatment.

Results: In group A, the number of exchanges done until the dialysate leucocyte counts decreased to <100/mL was 13.9 +/- 1.4 and for group B 6.6 +/- 0.4 (p<0.001). The reduction in neutrophils was significantly faster in group B compared to group A (p<0.001). The number of exchanges until abdominal pain completely disappeared was 12.5 +/- 1.7 in group A and 5.6 +/- 0.7 in group B (p<0.001).

Conclusions: The results of this study show that low-dose, continuous IP IgG administration in the treatment of PD-related peritonitis is safe and effective in shortening the treatment time.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Anti-Bacterial Agents
  • Dialysis Solutions
  • Drug Therapy, Combination / administration & dosage
  • Female
  • Humans
  • Immunoglobulin G / administration & dosage*
  • Leukocyte Count
  • Male
  • Middle Aged
  • Peritoneal Cavity
  • Peritoneal Dialysis, Continuous Ambulatory / adverse effects*
  • Peritonitis / etiology
  • Peritonitis / microbiology
  • Peritonitis / therapy*

Substances

  • Anti-Bacterial Agents
  • Dialysis Solutions
  • Immunoglobulin G