This study investigated the risk factors of
peritonitis during early
peritoneal dialysis for
renal failure in patients with
antineutrophil cytoplasmic antibody (
ANCA)-associated
systemic vasculitis (AASV). This study enrolled hospitalized AASV patients with
renal failure who underwent
peritoneal dialysis at the Department of Nephrology of our hospital between 2008 and 2015. The primary aim of this study was to perform a retrospective analysis to characterize
peritonitis during the early period (≤ 8 weeks) of dialysis, and to compare the differences in initial clinical manifestations,
vasculitis activity, immunosuppressive therapies prior to the
renal replacement therapy, and prognosis between patients with or without
peritonitis. The secondary aim of this study was to conduct a literature review of
peritoneal dialysis in patients with
vasculitis. All 14 enrolled AASV patients had
myeloperoxidase (MPO)-positive
microscopic polyangiitis (MPA). Six patients (of whom 2 died) withdrew from
peritoneal dialysis due to
peritonitis caused by enteric bacteria during the early period of dialysis. Their mean Birmingham
vasculitis activity score (BVAS) during the early AASV onset was 31.67 ± 3.98, with significant symptoms of gastrointestinal involvement. Also, their BVAS score, anti-MPO antibody titer, erythrocyte sedimentation rate,
C-reactive protein level, serum
ANCA level, and
glucocorticoid dose were higher than the AASV patients without
peritonitis (all p < 0.05). AASV patients with a higher level of
vasculitis (BVAS score > 30) during onset as well as gastrointestinal symptoms had a higher risk for intestinal
peritonitis. Therefore,
peritoneal dialysis is not recommended as a first-choice
renal replacement therapy for such patients.
.