Objective To investigate risk factors and outcomes of peritoneal dialysis(PD)associated fungal peritonitis(FP).Methods This single-center study retrospectively reviewed all FP episodes diagnosed from January 2017 to December 2022 in the PD center of Hangzhou Hospital of Traditional Chinese Medicine.And detailed data related to peritonitis episodes were recorded after matching 1:5 with patients diagnosed with bacterial peritonitis during the same period.Results A total of 22 fungal strains were detected in 19 cases of FP,including 7 strains of Pseudomonas albicans,5 strains of Candida smoothus,4 strains of Candida subsmoothus,and 2 strains of Candida tropicalis,One case of Candida inangulate,one curum,one Aspergillus flavus and one Cryptococcus lorrente.Compared with the non-FP group,the FP group had higher rates of previous antibiotic use(P<0.001)and peritonitis(P=0.015),longer duration of PD(P=0.012),lower plasma albumin(Alb)(P=0.006),and higher levels of high-sensitivity C-reactive protein(Hs-CRP)(P=0.034).The rate of conversion to hemodialysis(P<0.001)and automatic discharge(P=0.023)were higher.Kaplan-Meier survival curve analysis suggested no significant difference in survival rates between the two groups.Conclusion Previous antibiotic use,previous history of peritoneal dialysis associated peritonitis(PDAP),and long dialysis age are risk factors for FP.FP is a serious complication of PD and a major cause of conversion to hemodialysis and death within 3 months in patients on PD,and excessive antibiotic use should be guarded against.Following a confirmed diagnosis,initiate antifungal treatment as early as possible and consider early extubation.
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