Management of peritoneal dialysis related infections

Abstract

Introduction: Patients with end-stage renal disease who start active treatment with peritoneal dialysis have an increased risk of developing infections. Methods: This paper will present information from relevant professional/scientific sources regarding modern diagnostic and therapeutic modalities for the treatment of infections in patients on peritoneal dialysis. Topic: Infections associated with peritoneal dialysis are: peritoneal catheter exit site infections, tunnel infections and peritonitis. The symptoms of the mentioned infections vary from mild ones such as erythema and secretion at the exit point of the peritoneal catheter to pronounced symptomatology in the development of peritonitis accompanied by abdominal pain and elevated body temperature. The most common cause of peritonitis is infection of the exit site of the catheter, and the two main causes of infection are Staphylococcus aureus and Pseudomonas aeruginosa. If the existence of an infection is suspected, it is necessary to sample the dialysate for cytological examination and culture and to take a swab of the exit site of the catheter. Treatment begins with empiric antibiotic therapy, then it is corrected according to the antibiogram, and the exit site is treated locally with an antibiotic. If there is no therapeutic response after five days of intraperitoneal therapy in peritonitis, it is recommended to remove the catheter. Conclusion: According to the current guidelines of the International Society for Peritoneal Dialysis (ISPD), timely prevention of infections, diagnosis and treatment of peritoneal dialysis-related infections are necessary to prolong patient survival.