Peritoneal Dialysis in Patients with Malaria and Acute Kidney Injury

Abstract

PDITunnels or cysts covered with epithelial cells have been seen in specimens of chronic pyoderma or atheroma-diseases that are both frequently accompanied by bacterial infections.In that context, epithelialization around the Tenckhoff catheter throughout the subcutaneous tunnel, even if possible, may not be ideal for the prevention of bacterial or fungal infection.Although epidermal tissue has a barrier function, and keratinocytes produce many antimicrobial agents, the skin hosts a number of bacteria and fungi.In fact, ESIs are thought to be associated with epidermal downgrowth after a dead space is formed at the exit site, with accumulation of the products of skin metabolism.To prevent downgrowth, creation of an outwarddirected exit site at the time of surgery and avoidance of trauma in daily care would be desirable ways to avoid catheter infections. CONCLUSIONSEpithelium is absent from the subcutaneous tunnel in long-term PD patients.Because the exit site and the subcutaneous tunnel are not clearly differentiated histologically, diagnostic criteria to differentiate ESIs and TIs should be further explored.