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Transmission-based precautions are for patients known to be infected or suspected to be infected or colonized with organisms that pose a significant risk to others. Some transmission-based precautions include contact, enteric, and droplet.
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Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
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Retroperitoneal Laparoscopic Debridement and Drainage for Pancreatic Abscess
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Today's approaches to prevent peritonitis.

Beth Piraino1

  • 1Renal Electrolyte Division, Department of Medicine, Pittsburgh, Pa., USA.

Contributions to Nephrology
|June 2, 2012
PubMed
Summary

Peritonitis in peritoneal dialysis (PD) patients can be reduced through improved patient training and monitoring specific infection rates. Centers can achieve lower peritonitis rates by implementing best practices and exploring new technologies.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Public Health

Background:

  • Peritonitis remains a significant complication for patients undergoing peritoneal dialysis (PD).
  • There is considerable variation in peritonitis rates across different treatment centers.
  • Achieving low peritonitis rates, similar to centers of excellence, is a feasible goal for all centers.

Purpose of the Study:

  • To highlight strategies for reducing peritonitis rates in PD patients.
  • To emphasize the importance of organism-specific infection monitoring and patient education.
  • To discuss current and potential future interventions for peritonitis prevention.

Main Methods:

  • Review of existing literature and clinical practices for peritonitis prevention in PD.
  • Analysis of organism-specific infection rates, particularly coagulase-negative staphylococcus (CNS) and enteric peritonitis.

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  • Discussion of technological advancements, prophylactic treatments, and the need for further randomized controlled trials (RCTs).

    • Main Results:

    • Routine monitoring of organism-specific rates, rather than proportions, is critical for lowering peritonitis.
    • Patient training and retraining are key, with CNS peritonitis rates serving as a benchmark for training adequacy.
    • New connectology and prophylactic protocols (e.g., exit site treatments, probiotics, managing hypokalemia) show promise.

    Conclusions:

    • All centers can achieve low peritonitis rates through systematic monitoring and implementation of best practices.
    • Patient education, technological innovation, and targeted prophylactic measures are essential for reducing PD-related peritonitis.
    • Further research, including multicenter RCTs, is needed to validate novel prevention strategies.