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Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

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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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Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
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Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
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Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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Articles linked to this work by shared authors, journal, and citation graph.

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Xerosis elevates the risk of catheter-related infections in peritoneal dialysis patients.

Kidney research and clinical practice·2026
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Incremental start and clinical outcomes in peritoneal dialysis: International results from PDOPPS.

Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis·2025
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Risk Factors for Disease Progression for Adults and Children With Membranous Nephropathy in the Cure Glomerulonephropathy Network (CureGN).

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Updated: Dec 31, 2025

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Peritoneal Dialysis-Related Infection Rates and Outcomes: Results From the Peritoneal Dialysis Outcomes and Practice

Jeffrey Perl1, Douglas S Fuller2, Brian A Bieber2

  • 1Arbor Research Collaborative for Health, Ann Arbor, MI; St Michael's Hospital, Toronto, Canada.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|January 15, 2020
PubMed
Summary

Peritoneal dialysis (PD) peritonitis rates vary internationally, influenced by facility practices like automated PD use and training duration. Implementing specific strategies can reduce peritonitis risk in PD patients.

Keywords:
PD-related infectionPeritoneal Dialysis and Outcomes Practice Patterns Study (PDOPPS)Peritoneal dialysis (PD)bacterial infectionbest practicescausative organismepidemiologyfacility practiceshospitalizationinternational comparisonsmicrobiologyperitonitisperitonitis preventiontechnique failure

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Area of Science:

  • Nephrology
  • Epidemiology
  • Public Health

Background:

  • Peritoneal dialysis (PD)-related peritonitis is a significant complication for PD patients, leading to high morbidity.
  • Understanding peritonitis risk factors and rates is crucial for developing effective prevention strategies.

Purpose of the Study:

  • To analyze peritonitis rates across different countries participating in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS).
  • To investigate the association between facility practices and the risk of peritonitis in PD patients.

Main Methods:

  • An observational prospective cohort study involving 7,051 adult PD patients across 209 facilities in 7 countries.
  • Data collected on facility characteristics, patient demographics, and specific practices such as automated PD use, solution types, antibiotic prophylaxis, and training duration.
  • Peritonitis rates were analyzed using Poisson regression and proportional rate models, adjusted for patient case-mix variables.

Main Results:

  • A crude peritonitis rate of 0.28 episodes/patient-year was observed, with significant international variation (e.g., 0.40 in Thailand vs. 0.26 in the US).
  • Higher automated PD use, antibiotic use at catheter insertion, and longer PD training (≥6 days) were associated with lower peritonitis risk.
  • Facility size in Japan showed a positive association with peritonitis risk.

Conclusions:

  • Significant international disparities in PD-related peritonitis risk exist, potentially linked to modifiable facility practices.
  • Findings suggest that optimizing practices like automated PD, antibiotic prophylaxis, and training duration could lower peritonitis rates.
  • These results may inform future guidelines for setting maximally acceptable peritonitis rates.