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Laparoscopic-Assisted Seldinger Technique for Peritoneal Dialysis Catheter Insertion
Published on: May 23, 2025
Peritoneal dialysis-associated peritonitis with simultaneous exit-site infection
Rajnish Mehrotra1, Harmanjit Singh
1Department of Medicine, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA. rmehrotr@uw.edu
Clinical Journal of the American Society of Nephrology : CJASN
|September 8, 2012
Summary
Peritonitis is a rare complication of peritoneal dialysis, with most cases treatable. Catheter removal may be necessary for specific infections or treatment failures, with replacement timing varying.
Area of Science:
- Nephrology
- Infectious Diseases
- Dialysis Medicine
Background:
- Peritonitis, an infrequent complication of peritoneal dialysis (PD), has seen reduced incidence due to best demonstrated clinical practices.
- However, the reduction in peritonitis risk is not uniform across all centers.
Observation:
- Most peritonitis episodes do not require hospitalization, achieving cure rates of 70%-80%.
- Certain conditions necessitate peritoneal dialysis catheter removal, including inadequate antimicrobial response, fungal peritonitis, or Staphylococcus aureus/Pseudomonas peritonitis with concurrent exit-site infection.
Findings:
- Catheter removal in active intraperitoneal infection requires deferral of replacement by 2-4 weeks.
- Simultaneous removal and replacement is feasible in select cases, such as S. aureus or Pseudomonas peritonitis with coexisting exit-site infection, once intraperitoneal infection responds to antibiotics.
Implications:
- Optimizing PD management requires understanding specific indications for catheter removal and appropriate replacement timing.
- Tailored strategies for managing peritonitis and associated infections can improve patient outcomes in peritoneal dialysis.
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