Complications of the peritoneal access and their management

Although peritoneal catheter insertion is relatively considered a minimal invasive procedure, it is associated with some complications. These complications are divided into mechanical (bleeding, visceral perforation, dialysate leaks, catheter dysfunction, hernia formation, cuff extrusion) and infectious (early peritonitis, surgical wound, tunnel and exit site infections). It is well recognized that the appearance of these complications can increase morbidity and the chance of peritoneal dialysis treatment failure. Independent of the insertion technique, the operator must be prepared to an immediate recognition and adequate management of complications. Pre-operative evaluation and identification of potential risk factors are essential to prevent them.