Access-related complications in peritoneal dialysis in developing countries

Access-related complications differ considerably between acute and chronic peritoneal dialysis as a result of differences in catheter design, catheter material, number of cuffs, break in period, and the duration of peritoneal dialysis. Pain, which is the commonest complication of acute peritoneal dialysis, is seen in 56% to 75% followed by blood tinged dialysate effluent in 30%, pericatheter leak in 14% to 36%, catheter malfunction in 12% to 28%, bowel injury in 0.1% to 1.3%, rarely bladder injury and peritonitis in 2.5%. In chronic peritoneal dialysis, the incidence of exit-site infections are seen anywhere between 1 episode in 27.3 patients months to 1 episode in 41.9 patients months, and pericatheter leak is seen in 5.2%. Technique of exit-site care is variable in different countries, and regular use of mupirocin ointment at the exit site is practiced in different centers.