Abstract: FR-PO1108
Trends and Characteristics of Nontuberculous Peritonitis in Patients on Peritoneal Dialysis
Session Information
- Home Dialysis: Modalities, Barriers, Utilization, and Clinical Outcomes
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Menghrajani, Rajiv Hans Solita, NYC Health + Hospitals, New York, New York, United States
- Macasaet, Raymart S., Monmouth Medical Center, Long Branch, New Jersey, United States
- Salonga, Patricia, Monmouth Medical Center, Long Branch, New Jersey, United States
- Tang, Samantha Yu, NYC Health + Hospitals, New York, New York, United States
- Shetty, Disha C., Monmouth Medical Center, Long Branch, New Jersey, United States
- Shah, Ankur, Brown University Warren Alpert Medical School, Providence, Rhode Island, United States
Background
Peritonitis is the most serious infectious complication of peritoneal dialysis (PD), but non-tuberculous mycobacterial (NTM) peritonitis is uncommon and poorly characterized. NTM organisms are intrinsically resistant to standard empiric regimens used for bacterial peritonitis, and infection is associated with delayed diagnosis, catheter removal, and transition to hemodialysis (HD). Real-world data on demographics, temporal trends, and short-term outcomes remain limited.
Methods
Using the TriNetX database, we identified adults with end-stage renal disease (ICD-10 N18.6) on PD, defined by SNOMED 71192002 or ICD-10-PCS 3E1M39Z (irrigation of peritoneal cavity using dialysate); patients with tuberculosis (ICD-10 A15–A19) were excluded. Within this PD cohort, we identified an NTM peritonitis subgroup with peritonitis (ICD-10 K65 or T85.71XD) co-occurring with NTM infection (ICD-9 031, ICD-10 A31.8, or A31.9) on or after PD initiation. Demographics, 30- and 90-day catheter exchange, transition to HD, and mortality were assessed, and incidence and prevalence were calculated across five-year windows from 2001 to 2025.
Results
We identified 96 PD patients with NTM peritonitis (mean age 62.2 ± 15.2 years; 63.5% male). The cohort was racially diverse (White 39.6%, Black 36.5%, Asian 14.6%, Native Hawaiian or Other Pacific Islander 10.4%); 10.4% identified as Hispanic or Latino. Prevalence rose from 0% in 2001–2005 to 0.29% (2006–2010), 0.273% (2011–2015), 0.659% (2016–2020), and 1.095% in 2021–2025. Within 30 days of diagnosis, 12.5% transitioned to HD. By 90 days, 12 deaths (12.5%) had occurred and 26% had required catheter exchange.
Conclusion
The incidence and prevalence of NTM peritonitis among PD patients have increased substantially over the past two decades, with the highest burden in 2021–2025. The infection disproportionately affects older, predominantly male patients across diverse racial groups and is associated with substantial early morbidity, including frequent catheter loss, transition to HD, and 12.5% 90-day mortality. These findings underscore the need for heightened clinical suspicion and early mycobacterial culture in PD patients with refractory peritonitis.