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[Exit-site infection in peritoneal dialysis]
1IRCCS Ospedale Maggiore Policlinico, Milan. deveccpd@policlinico.mi.it
Summary
Exit-site infections are common in peritoneal dialysis (PD), potentially leading to peritonitis or catheter loss. Prompt diagnosis and adherence to guidelines are crucial for successful treatment and preventing complications.
Area of Science:
- Nephrology
- Infectious Diseases
Context:
- Exit-site infection (ESI) is a significant complication in peritoneal dialysis (PD).
- ESIs can progress to peritonitis and necessitate PD catheter removal.
- Understanding ESI natural history is vital for patient management.
Purpose:
- To describe the natural history of peritoneal dialysis exit-site infections.
- To review and analyze preventive strategies for ESIs.
- To examine diagnostic and therapeutic approaches for ESIs.
Summary:
- This paper details the evolution of exit-site infections in PD, including risk factors like Staphylococcus nasal carriage.
- Preventive measures encompass surgical techniques, perioperative care, and exit-site management.
- Diagnostic tools and medical therapies, guided by international standards, are discussed, emphasizing timely intervention.
Impact:
- Effective management of ESIs can prevent secondary peritonitis and catheter loss.
- Minimally invasive interventions, such as partial catheter removal, can avoid hemodialysis and reduce surgical burden.
- Optimizing ESI treatment improves patient quality of life and reduces healthcare costs.