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Background: To date, it is unclear whether SARS-CoV-2 is present in spent dialysate from patients with COVID-19 on peritoneal dialysis (PD). Our aim was to assess the presence or absence of SARS-CoV-2 in spent dialysate from patients on chronic PD who had a confirmed diagnosis of COVID-19., Methods: Spent PD dialysate samples from patients on PD who were positive for COVID-19 were collected between March and August 2020. The multiplexed, real-time RT-PCR assay contained primer/probe sets specific to different SARS-CoV-2 genomic regions and to bacteriophage MS2 as an internal process control for nucleic acid extraction. Demographic and clinical data were obtained from patients' electronic health records., Results: A total of 26 spent PD dialysate samples were collected from 11 patients from ten dialysis centers. Spent PD dialysate samples were collected, on average, 25±13 days (median, 20; range, 10-45) after the onset of symptoms. The temporal distance of PD effluent collection relative to the closest positive nasal-swab RT-PCR result was 15±11 days (median, 14; range, 1-41). All 26 PD effluent samples tested negative at three SARS-CoV-2 genomic regions., Conclusions: Our findings indicate the absence of SARS-CoV-2 in spent PD dialysate collected at ≥10 days after the onset of COVID-19 symptoms. We cannot rule out the presence of SARS-CoV-2 in spent PD dialysate in the early stage of COVID-19., Competing Interests: J.E. Chao, G.F. Dias, N. Grobe, M. Hakim, M. Han, O. Thwin, Z. Haq, P. Kotanko, A. Patel, P. Preciado, J. Raimann, X. Tao, L. Tisdale, X. Wang, and X. Ye are employees of the Renal Research Institute, a wholly owned subsidiary of FMCNA. D. Chatoth and R. Lasky are employees of FMCNA. D. Chatoth and P. Kotanko hold stock in Fresenius Medical Care. All remaining authors have nothing to disclose., (Copyright © 2021 by the American Society of Nephrology.)

Background: Fungal Peritonitis (FP) is an uncommon but potentially serious and fatal complications of Chronic Peritoneal Dialysis (CPD), it accounts for 1-15% of all peritonitis episodes. The morbidity and mortality rates are very high varies from 20% to 30% ((Matuszkiewicz-Rowinska 2009). Methods: We retrospectively analyzed all pediatric PD patients treated at Soba University Hospital (SUH) from June 2005 to June 2015. Descriptive statistics of patient demographics, primary causes of ESRD leading to dialysis and clinical outcomes including episodes of fungal peritonitis with particular attention to identify risk factors for causes like antibiotic usage preceded the fungal infection, specific type of fungus causing peritonitis, treatment guidelines, and patient outcome data. FP was diagnosed based on effluent cell count and positive fungal culture. Results: Data from 120 pediatric patients who received treatment during the study period were included in this analysis (44% male, median age 10 years [1-17 years], median length of PD 350 days). Fifty-two cases of peritonitis were recorded, 46 first episodes and 6 secondary episodes. The rate of first peritonitis episode was one episode per 3.35 years of follow-up. The rate of second peritonitis episode was one episode per 18.5 years of follow up. Of the total 52 episodes of peritonitis in these patients occurring over 2,096 patient-months of follow-up, FP accounted for 5 (2.9%) of the episodes. The patients on PD who developed FP were similar to those who did not develop FP with regard to dialysis modality, dialysis access characteristics, and primary cause of ESRD. Two of them were males and three were females. The overall peritonitis rate in patients who developed FP was 0.05 episodes per patient-year compared with 0.02 episodes per patient-year in the patients who did not develop this infection (P = 0.095). In 2 cases, the FP was the patient's initial episode of peritonitis. Whereas recent antibiotic usage was present in 3 of patients with FP. Candida species were cultured from 4 patients accounting 80% (three of them had C. Albicans and one had C. Parapsilosis) and Aspergillus Fumigatus from one patient 20%. Successful management of FP consists of a combination of prompt removal of the PD catheter and intravenous administration of anti-fungal for 4-6 weeks. Four patients transferred to Hemodialysis (HD) after catheter removal, one travelled abroad. Only one patient was put back on CAPD after 8 weeks (failure to resume PD occurs in 4 patients). Conclusions: FP is rarer than BP in our CPD population but has worse prognosis with a significant CPD drop-out rate. FP can be managed in many patients with a combination of antifungal therapy, prompt catheter removal, and temporary hemodialysis. The role of FP in CAPD peritonitis has received relatively little attention. Further studies are required. [ABSTRACT FROM AUTHOR]