Imaging work-up for peritoneal access care and peritoneal dialysis complications

Area of Science:

• Radiology
• Nephrology
• Gastroenterology

Background:

• Peritoneal dialysis (PD) is a vital treatment for end-stage renal failure.
• PD complications, primarily infections and mechanical issues, can necessitate treatment cessation.
• Effective diagnosis of PD complications is essential for patient management.

Purpose of the Study:

• To review radiologic investigations for diagnosing PD complications.
• To guide the appropriate selection of imaging modalities for PD-related issues.

Main Methods:

• Review of radiologic investigations including plain radiography, ultrasonography (US), peritoneography, CT peritoneography, MR peritoneography, and peritoneal scintigraphy.
• Evaluation of imaging utility for specific PD complications like infections and mechanical failures.

Main Results:

• Plain radiography, US, and peritoneography aid in diagnosing catheter-related problems.
• US is effective for exit-site and tunnel infections.
• Peritoneography and CT-peritoneography are gold standards for mechanical complications (malfunction, leaks, hernias, sclerosing peritonitis).
• MR peritoneography and scintigraphy may be useful in select cases.

Conclusions:

• Appropriate use of diagnostic radiology significantly improves PD technique survival, morbidity, and mortality.
• Imaging plays a critical role in the diagnosis and treatment decisions for PD complications.