Relapsing peritonitis in continuous ambulatory peritoneal dialysis and an unconventional approach to treatment

Area of Science:

• Nephrology
• Infectious Diseases
• Surgical Innovation

Background:

• Relapsing peritonitis is a common complication in peritoneal dialysis (PD).
• Persistent catheter-related infections are the usual cause when intra-abdominal pathology is excluded.
• Standard treatment often involves catheter removal for cure.

Observation:

• A patient experienced recurrent episodes of peritonitis despite appropriate antibiotic therapy.
• The patient had a presternal peritoneal dialysis catheter.
• Intra-abdominal pathology was ruled out as a cause.

Findings:

• Partial removal of the presternal PD catheter led to the complete resolution of relapsing peritonitis.
• This suggests a less invasive approach may be effective in select cases.

Implications:

• Partial catheter removal could be a viable alternative to complete removal in managing refractory peritonitis.
• This approach may preserve PD catheter function and patient quality of life.
• Further investigation into the efficacy of partial catheter removal is warranted.