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Peritoneal dialysis infections recommendations.

Beth Piraino1

  • 1University of Pittsburgh, Pittsburgh, Pa., USA.

Contributions to Nephrology
|May 25, 2006
PubMed
Summary

Peritonitis in peritoneal dialysis (PD) patients is a significant cause of technique failure and mortality. Implementing strict protocols for handwashing, exit-site care, and prompt antibiotic treatment can reduce infectious complications.

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Peritoneal Dialysis

Background:

  • Peritonitis is a major complication in peritoneal dialysis (PD), leading to technique failure and mortality.
  • Infections often arise from contamination during exchanges or from exit-site infections.

Purpose of the Study:

  • To review strategies for preventing and managing peritonitis in PD patients.
  • To highlight the importance of protocols in reducing infectious complications.

Main Methods:

  • Review of existing literature and clinical practices for peritonitis management in PD.
  • Emphasis on preventative measures like aseptic techniques and antibiotic prophylaxis.
  • Discussion of treatment protocols for established peritonitis and exit-site infections.

Main Results:

  • Effective prevention strategies include rigorous training in aseptic techniques and proper connection procedures.
  • Exit-site antibiotic prophylaxis, particularly with gentamicin, can reduce infections caused by S. aureus and P. aeruginosa.
  • Prompt and appropriate antibiotic therapy is crucial for resolving peritonitis; catheter removal may be necessary for refractory or relapsing cases, especially fungal peritonitis.

Conclusions:

  • Implementing comprehensive protocols for infection prevention and management is essential for reducing infectious complications in PD.
  • Careful attention to causative organisms and infection rates is vital for PD centers.
  • Further research is needed to address mortality and peritoneal damage associated with infections.

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