Peritonitis - dialysis associated Health Article

Definition

Dialysis-associated peritonitis is inflammation of the lining of the abdominal cavity (peritoneum), which occurs in those who receive peritoneal dialysis.

Alternative Names

Dialysis-associated peritonitis

Causes, incidence, and risk factors

Dialysis-associated peritonitis may be caused by bacteria that get into the area during the dialysis procedure. Skin bacteria or fungi can cause the infection.

Approximately one infection occurs for every 15 months of peritoneal dialysis.

Symptoms

• Abdominal tenderness
• Distended abdomen
• Nausea and vomiting

Other symptoms that can occur with this disease:

• Chills
• Fever

Signs and tests

The doctor will do a physical examination and may find that your abdomen is tender when touched. There may be some discharge from the site where the catheter used for dialysis enters the skin. Dialysis fluid may be cloudy.

Tests that can show infection include:

• Blood culture
• Complete blood count (CBC)
• Peritoneal fluid culture, cell count and gram stain

Treatment

The goal of treatment is to cure the infection. Antibiotics are given into a vein (intravenous injection) or into the lining of the abdomen (peritoneum).

Laboratory tests that show which bacteria or fungi are causing the infection will determine the type of antibiotic used.

Expectations (prognosis)

Most patients recover.

Complications

• Catheter-associated urinary tract infection
• Intraabdominal abscess
• Recurrent peritonitis

You may need to have the dialysis catheter removed.

Calling your health care provider

Call your health care provider if you receive peritoneal dialysis treatments and develop symptoms of peritonitis.

Prevention

Careful sterile technique when performing peritoneal dialysis may help reduce the risk of inadvertently introducing bacteria during the procedure. Some cases are not preventable. Equipment design improvements have made these infections less common.