Abstract: Objective To evaluate the incidence, pathogenic fungi, treatment and prognosis of peritoneal dialysis-associated fungal peritonitis (FP). Methods The clinical data of 18 cases of FP in the peritoneal dialysis center of the Second Affiliated Hospital of the Army Medical University from January 2010 to October 2019 were retrospective analyzed. The clinical data, treatment methods and outcomes of all FP patients were recorded and compared with those of 113 cases of no fungal peritonitis. Results Three hundred and eighty nine cases of peritoneal dialysis-related peritonitis were reviewed, FP accouted for 4.6%. There were 6 cases (33.3%) of Candida albicans, 5 cases (27.8%) of Candida parapsilosis, 3 cases (16.7%) of Candida famata, 2 cases (11.1%) of Candida smooth, 1 case of Candida tropical (5.6%) and 1 case of Candida krusei(5.6%). Compared to no fungal peritonitis group, The FP group showed the longer duration of peritoneal dialysis (P<0.001), higher rate of previous antibiotic use (P<0.001), lower serum albumin (P<0.001), higher c-reactive protein (P<0.001), higher intact parathyroid hormone (P<0.001) and higher phosphorus (P<0.001). Logistic regression analysis showed that the longer duration of peritoneal dialysis, antibiotic use within 1 month, hypoalbuminemia and high c-reactive protein were risk factors for FP (P<0.05). Among the 18 FP patients, 14 patients (77.8%) were removed the catheter to maintenance hemodialysis and 4 patients (22.2%) died. The technique failure rate of peritoneal dialysis and mortality in FP group was significantly higher than that in no fungal peritonitis group. Conclusion Long term peritoneal dialysis, previous use of antibiotics, hypoalbuminemia and high c-reactive protein were high risk factors for FP. FP was a serious complication of peritoneal dialysis and a major cause of technical failure. Early catheter removal after diagnosis could reduce the mortality of FP.

Key words: peritoneal dialysis, fungal peritonitis, antifungal treatment, predisposing factors