188 32nd World Congress of Internal Medicine (October 24-28, 2014) WCIM 2014
PS 0546 Nephrology
Body Composition Measurements Using Bioimpedance Analysis in Peritoneal Dialysis Patients are Affected by the Resence of Dialysate
Kyu Hyang CHO1, Seok Hui KANG1, Jong Won PARK1, Kyung Woo YOON1, Jun Young DO1 Yeungnam University Mecical Center, Korea1
Background: We report a rare case of CAPD peritonitis caused by Ochrobacterium anthropi.
Introductions: Among the continuous ambulatory peritoneal dialysis(CAPD) patients, peritonitis is one of the most commonly taken complications, and also the general cause of dialytic modality exchange to hemodialysis. Usual pathogens of CAPD peri- tonitis may be bacteria, fungi, mycobacteria. Coagulase negative staphylococci, S.
aureus, campylobacter, pseudomonas are common reported pathogens among the bacteria, of CAPD peritonitis cases, meanwhile candida is among fungi. Ochrobacteri- um anthropi is one species of Brucellaceae, which is rare pathogen of human disease.
Case (Methods and results): 73 years old female, who was on CAPD due to diabetic end stage renal disease visited Kyung-Hee University hospital with intermittent ab- dominal pain. Body fl uid analysis showed increased white blood cell(WBC) count of 26,750/mm3 with her peritoneal fl uid. Culture study with peritoneal fl uid suggested O.
anthropi, and DNA sequencing with PCR was consistent with O. anthropi. Intraperito- neal ceftazidime and cefazolin were administrated as empirical antibiotics. Ceftazidime resistance was noted with the result of antibiotics sensitivity test at 7th day of hospi- talization, and antibiotics were changed into intraperitoneal gentamicin, which showed sensitivity to the pathogen. CAPD catheter removal and antibiotics re-exchange into imipenem and cefazolin, which were other sensitive antibiotics by the sensitivity test, were done since clinical manifestation and peritoneal fl uid WBC count was repeatedly improved and aggravated. The patient discharged with improved lab test results and resolving clinical symptoms afterward.
Conclusions: We presentators report rare case of CAPD peritonitis with pathogen of O. anthropi. The pathogen of the case confi rmed by classical microbiologic, and mo- lecular biologic Methods: The patient was unable to treat only with antibiotics, thus CAPD catheter, which might be act as colonizing source, was removed, and the disease resolved.
PS 0547 Nephrology
Geriatric Nutritional Risk Index May be a Signifi cant Nutritional Factor in Renal Transplantation Patients According to the Presence or Absence of Chronic Kid- ney Disease
Hark RIM1, Sunmin KIM1, Gyoung-Hoon KANG1, Ye Na KIM1, Ho Sik SHIN1, Yeon Soon JUNG1, Hyun Yul RHEW2
Department of Internal Medicine, Kosin University Gospel Hospital, Korea1, Department of Urology, Kosin University Gospel Hospital, Korea2
Background: We report a rare case of CAPD peritonitis caused by Ochrobacterium anthropi.
Introductions: Among the continuous ambulatory peritoneal dialysis(CAPD) patients, peritonitis is one of the most commonly taken complications, and also the general cause of dialytic modality exchange to hemodialysis. Usual pathogens of CAPD peri- tonitis may be bacteria, fungi, mycobacteria. Coagulase negative staphylococci, S.
aureus, campylobacter, pseudomonas are common reported pathogens among the bacteria, of CAPD peritonitis cases, meanwhile candida is among fungi. Ochrobacteri- um anthropi is one species of Brucellaceae, which is rare pathogen of human disease.
Case (Methods and results): 73 years old female, who was on CAPD due to diabetic end stage renal disease visited Kyung-Hee University hospital with intermittent ab- dominal pain. Body fl uid analysis showed increased white blood cell(WBC) count of 26,750/mm3 with her peritoneal fl uid. Culture study with peritoneal fl uid suggested O.
anthropi, and DNA sequencing with PCR was consistent with O. anthropi. Intraperito- neal ceftazidime and cefazolin were administrated as empirical antibiotics. Ceftazidime resistance was noted with the result of antibiotics sensitivity test at 7th day of hospi- talization, and antibiotics were changed into intraperitoneal gentamicin, which showed sensitivity to the pathogen. CAPD catheter removal and antibiotics re-exchange into imipenem and cefazolin, which were other sensitive antibiotics by the sensitivity test, were done since clinical manifestation and peritoneal fl uid WBC count was repeatedly improved and aggravated. The patient discharged with improved lab test results and
resolving clinical symptoms afterward.
Conclusions: We presentators report rare case of CAPD peritonitis with pathogen of O. anthropi. The pathogen of the case confi rmed by classical microbiologic, and mo- lecular biologic Methods: The patient was unable to treat only with antibiotics, thus CAPD catheter, which might be act as colonizing source, was removed, and the disease resolved.
PS 0548 Nephrology
Onodera’s Prognostic Nutritional Index May be a Sig- nifi cant Nutritional Factor in Renal Transplantation Pa- tients According to the Presence or Absence of Chronic Kidney Disease
Gyoung-Hoon KANG1, Jiin KANG1, Ye Na KIM1, Ho Sik SHIN1, Yeon Soon JUNG1, Hark RIM1, Hyun Yul RHEW2
Department of Internal Medicine, Kosin University Gospel Hospital, Korea1, Department of Urology, Kosin University Gospel Hospital, Korea2
Background: Evaluation of nutritional status is essential clinical procedures for man- aging renal transplantation patients, especially in status of chronic kidney disease (CKD). However, no standard method for assessing the nutritional status in renal transplantation patients exists. Onodera’s Prognostic Nutritional Index (OPNI) is a method that considers serum albumin level and total lymphocyte count. This simple method may involve common measures and can be applied rapidly in a large number of patients. Validation of OPNI has been performed for patients with end-stage liver disease, active tuberculosis, and gastrointestinal malignancies.
Methods: We examined the OPNI scores of 184 renal transplantation patients (50.2
± 11.3 years; 115 men and 69 women). The OPNI is calculated based on the serum albumin level and total lymphocyte count and uses the following equation: OPNI = 10
× serum albumin (g/dL) + 0.005 × total lymphocyte count (/mL). Logistic regression analysis was performed for predicting malnutrition in renal transplantation patients.
Results: The average OPNI value was 48.9 ± 7.1, and OPNI values were normally distributed. According to logistic regression for predicting malnutrition, male, total lymphocyte count and chronic kidney disease predicted malnutrition.
Conclusions: These results suggest that OPNI may be a signifi cant nutritional marker in renal transplantation patients. The simple OPNI method is a clinically useful marker for the assessment of nutritional status in renal transplantation patients
