What is peritonitis in peritoneal dialysis?
Peritonitis is inflammation of the peritoneum, the inside lining of your own belly that acts as a natural filter. In peritoneal dialysis, waste products are removed through the peritoneum with a cleansing fluid called dialysate, which is washed in and out of your abdominal cavity (belly) in cycles.
Is peritonitis a complication of peritoneal dialysis?
Background: Over the past two decades, the rate of peritonitis in patients treated by peritoneal dialysis (PD) has been significantly reduced. However, peritonitis remains a major complication of PD, accounting for considerable mortality and hospitalization among PD patients.
How common is peritonitis with peritoneal dialysis?
Peritonitis is a common and serious complication of peritoneal dialysis (PD). PD-associated peritonitis is the direct or major contributing cause of death in >15% of patients on PD (1,2).
What should be done if peritonitis occurs in patients undergoing PD?
Generally, patients with culture-negative peritonitis do well. Peritoneal fluid should be reevaluated at day 3 to assess response to therapy. 2 Those who respond to initial empiric therapy can have their Gram-negative antibiotic discontinued, and can be treated with 2 weeks of vancomycin or cefazolin.
What are the complications of peritonitis?
Complications of peritonitis include tertiary peritonitis, infection or dehiscence of the surgical site, enterocutaneous fistula, abdominal compartment syndrome, and enteric insufficiency.
What is secondary peritonitis?
Secondary bacterial peritonitis describes peritoneal infections secondary to intraabdominal lesions, such as perforation of the hollow viscus, bowel necrosis, nonbacterial peritonitis, or penetrating infectious processes.
What is the best treatment for peritonitis?
Peritonitis treatment usually involves antibiotics and, in some cases, surgery. Left untreated, peritonitis can lead to severe, potentially life-threatening infection throughout your body. A common cause of peritonitis is peritoneal dialysis therapy.
What is the International Society for peritoneal dialysis (ISPD) recommendation for PD-associated peritonitis?
Detailed recommendations on the prevention and treatment of PD-associated peritonitis have been published by the International Society for Peritoneal Dialysis (ISPD), but there is a substantial variation in clinical practice among dialysis units.
Is peritoneal dialysis a first-line dialysis modality for peritonitis?
After the improvement in clinical practice, there is a worldwide trend of reduction in PD-associated peritonitis rate, supporting the use of PD as a first-line dialysis modality. Peritonitis is a common and serious complication of peritoneal dialysis (PD).
What are the treatment options for peritonitis caused by peritoneal dialysis?
Prophylactic antibiotics administered before PD catheter insertion, colonoscopy, or invasive gynecologic procedures, daily topical application of antibiotic cream or ointment to the catheter exit site, and prompt treatment of exit site or catheter infection are key measures to prevent PD-associated peritonitis.
What is PD-associated peritonitis?
Peritonitis is a common and serious complication of peritoneal dialysis (PD). PD-associated peritonitis is the direct or major contributing cause of death in >15% of patients on PD (1, 2).