Peritoneal Dialysis Complications
Peritonitis:
• Can't miss! 6% of cases result in death
• Diagnostics:
1) evidence of peritonitis on exam
2) dialysis effluent WBC>100/uL with >50% pMNs.
3) positive dialysis effluent culture
• Remove catheter if: Refractory or Relapsing Peritonitis or Fungal Peritonitis
Site Infections:
• Risk Factors: Poor Exit Site Care, Catheter Mobilitization, Swimming, Presence of pets during exchange
• If persistent -> exchange catheter
Outflow Failure
• Incomplete recovery of instilled fluid
• Always evaluate for constipation
• Also see fibrin clots and catheter malpositioning
Membrane Failure: Insufficient flow across the peritoneal membrane
Catheter-Cuff Extrusion: Erosion of the cuff through the skin
Intestinal Perforation: Feculent/bloody dialysate, dialysate retention, diarrhea after instillation
- Dr. Taliya Lantsman @TLantsman via @iMedEducation
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