Peritoneal Dialysis–Associated Peritonitis: Suggestions for Management and Mistakes to Avoid

Abstract

Peritonitis is a common complication of peritoneal dialysis that is associated with substantial morbidity and mortality. Peritonitis increases treatment costs and hospitalization events and is the most common reason for transfer to hemodialysis. Although there is much focus on preventing peritoneal dialysis–associated peritonitis, equally as important is appropriate management to minimize the morbidity of a peritonitis episode when it has occurred. Despite the presence of international guidelines on peritonitis treatment, the evidence base to support optimal peritonitis treatment practices is lacking, leaving the practitioner to rely on clinical experience and extrapolate from across other infection treatment practices. This article reviews common mistakes and misconceptions that we have observed in the management of peritonitis that may compromise treatment success. It also provides suggestions on common controversial aspects of peritonitis management based on the best available literature. Although the use of the word mistakes is somewhat controversial and subjective, we acknowledge that evidence is lacking and have based many of our suggestions on clinical judgment, experience, and available data.

Spectrum of Complications of Patients with Chronic Kidney Disease on Maintenance Continuous Ambulatory Peritoneal Dialysis: An Experience of Tertiary Nephrology Center in Najaf City-Iraq

“…Comparable results were reported in several earlier clinical studies worldwide [45]. This complication could be associated with increase hospitalization, treatment cost, as well as raising the rate of mortality [25].…”

“…In spite of these advantages, but the PD has many of potential complications, infectious, and noninfectious. The infectious complications of PD include peritonitis that also known as a technique failure and this considered as the major complication of PD and primary cause that made patients to switch from PD to HD as well as increase risk of morbidity and mortality in addition to increasing treatment cost and hospitalization, infection of the catheter exit site, tunnel infection also reported [25], [26], [27], [28].…”

Foreign body ingestion-related peritonitis in an elderly peritoneal dialysis patient

“…Differentiating this from PD-related peritonitis can be difficult, since they can have both identical presentations. 2 Computed tomography (CT) can be useful for the detection of fluid collections, abscess, thickening of the small-bowel wall or adhesions, and ruling out other etiologies of abdominal sepsis. 3 We report a case of an elderly PD patient who presented peritonitis due to ileal perforation because of BPP ingestion.…”

Dialisis

“…La diálisis peritoneal se junta con los resultados equivalentes a la hemodiálisis, pero se puede generar en la mayoría de los países a costos más bajos (Al Sahlawi, 2020). Los pacientes que la reciben, por lo general poseen una buena calidad de vida y una alta satisfacción con su atención y llevan su estilo de vida independiente.…”