Serum Galactomannan: A Predictor of Poor Outcomes in Peritoneal Dialysis Patients With Fungal Peritonitis

被引：2

作者：

Kanjanabuch, Talerngsak ^{[1
,2
,3
]}

Nopsopon, Tanawin ^{[4
]}

Saejew, Thunvarat ^{[2
]}

Banjongjit, Athiphat ^{[5
]}

Puapatanakul, Pongpratch ^{[1
]}

Tungsanga, Somkanya ^{[1
,6
]}

Vanichanan, Jakapat ^{[7
]}

Tatiyanupanwong, Sajja ^{[8
]}

Tianprasertkij, Kanjana ^{[9
]}

Treamtrakanpon, Worapot ^{[10
]}

Parinyasiri, Uraiwan ^{[11
]}

Khositrangsikun, Kamol ^{[12
]}

Thamvichitkul, Oranan ^{[13
]}

Lorvinitnun, Pichet ^{[14
]}

Uppamai, Sriphrae ^{[15
]}

Lawsuwanakul, Rhonachai ^{[16
]}

Wanpaisitkul, Mananya ^{[17
]}

Chowpontong, Saowalak ^{[18
]}

Chieochanthanakij, Rutchanee ^{[19
]}

Eiam-Ong, Somchai ^{[1
]}

Perl, Jeffrey ^{[20
,21
]}

Johnson, David W. ^{[22
,23
,24
]}

机构：

[1] Chulalongkorn Univ, Fac Med, Dept Med, Div Nephrol, Bangkok 10330, Thailand

[2] Chulalongkorn Univ, Fac Med, Ctr Excellence Kidney Metab Disorders, Bangkok, Thailand

[3] King Chulalongkorn Mem Hosp, Peritoneal Dialysis Excellent Ctr, Bangkok, Thailand

[4] Chulalongkorn Univ, Fac Med, Dept Prevent & Social Med, Bangkok, Thailand

[5] Vichaiyut Hosp, Dept Med, Nephrol Unit, Bangkok, Thailand

[6] Univ Alberta, Fac Med & Dent, Dept Med, Div Nephrol & Immunol, Edmonton, AB, Canada

[7] Chulalongkorn Univ, Fac Med, Dept Med, Div Infect Dis, Bangkok, Thailand

[8] Chaiyaphum Hosp, Dept Internal Med, Nephrol Div, Chaiyaphum, Thailand

[9] Sakaeo Crown Prince Hosp, Dialysis Unit, Sakaeo, Thailand

[10] Chaophraya Abhaibhubejhr Hosp, Dept Med, Prachin Buri, Thailand

[11] Songkhla Hosp, Dept Internal Med, Kidney Dis Clin, Songkhla, Thailand

[12] Maharaj Nakhon Si Thammarat Hosp, Dept Internal Med, Renal Unit, Nakhon Si Thammarat, Thailand

[13] Sisaket Hosp, Dialysis Unit, Sisaket, Thailand

[14] Sunpasitthiprasong Hosp, Dept Med, Ubon Ratchathani, Thailand

[15] Sukhothai Hosp, Dept Internal Med, Sukhothai, Thailand

[16] Chonburi Hosp, Dept Med, Div Nephrol, Chon Buri, Thailand

[17] Banpong Hosp, Dept Med, Div Nephrol, Ratchaburi, Thailand

[18] Phra Nakhon Si Ayutthaya Hosp, Dept Med, Div Nephrol, Phra Nakhon Si Ayutthaya, Thailand

[19] Sawanpracharak Hosp, Dialysis Unit, Nakhon Sawan, Thailand

[20] St Michaels Hosp, Li Ka Shing Knowledge Inst, Div Nephrol, Toronto, ON, Canada

[21] St Michaels Hosp, Li Ka Shing Knowledge Inst, Keenan Res Ctr, Toronto, ON, Canada

[22] Princess Alexandra Hosp, Dept Kidney & Transplant Serv, Div Med, Woolloongabba, Qld, Australia

[23] Univ Queensland, Ctr Hlth Serv Res, Australasian Kidney Trials Network, Brisbane, Australia

[24] Translat Res Inst, Ctr Kidney Dis Res, Brisbane, Australia

来源：

KIDNEY INTERNATIONAL REPORTS | 2024年 / 9卷 / 02期

关键词：

fungal peritonitis; galactomannan; GM cut-off value; MycoPDICS; peritoneal dialysis; predictor; INFECTIOUS-DISEASES SOCIETY; INVASIVE ASPERGILLOSIS; PRACTICE GUIDELINES; DIAGNOSIS; MICROBIOLOGY; UPDATE; ASSAY;

D O I：

10.1016/j.ekir.2023.11.002

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: The potential value of serum galactomannan index (GMI) in monitoring treatment response in patients with fungal peritonitis who are receiving peritoneal dialysis (PD) was assessed in the present study. Methods: The study included all Thailand fungal PD -related infectious complications surveillance (MycoPDICS) DATA study participants who had timely PD catheter removal and availability of both baseline and $2 subsequent serum GMI measurements after starting antifungal therapy (if available). Serum GMI was assessed by direct double -sandwich enzyme -linked immunosorbent assay with reference to positive and negative control samples. Comparisons of categorical variables among groups were analyzed by Fisher's exact test for categorical data and the Wilcoxon rank -sum test for continuous variables. Mortality outcomes were analyzed by survival analyses using Kaplan -Meier curves with Log -rank test. Results: Seventy-six (46%) of 166 participants from 21 PD centers between 2018 and 2022 were included. The median age was 58 (50-65) years, and a half of the patients (50%) had type II diabetes. Nineteen (25%) and 57 (75%) episodes were caused by yeast and mold, respectively. Death occurred in 11 (14%) patients at 3 months, and no differences were observed in demographics, laboratories, treatment characteristics, or in baseline serum GMI between those who died and those who survived. Serum GMI progressively declined over the follow-up period after the completion of treatment. Patients who died had significantly higher posttreatment serum GMI levels and were more likely to have positive GMI after treatment. Conclusion: Serum GMI is an excellent biomarker for risk stratification and treatment response monitoring in patients on PD with fungal peritonitis. 2023 International Society of Nephrology. Published by Elsevier Inc. This is an open access article under the CC BY - NC -ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

引用

页码：287 / 295

页数：9

共 26 条

[1] Variation in Peritoneal Dialysis-Related Peritonitis Outcomes in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) [J].