Related Experiment Video
Updated: Jul 12, 2025
06:27
A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
Published on: July 20, 2022
2.6K
Conversion from Intermittent Hemodialysis to Peritoneal Dialysis in Metastatic Catheter-Related Bloodstream Infection
Mohamedanwar Ghandour1, Ravi K Thimmisetty1, James Sondheimer1
1Division of Nephrology and Hypertension, Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI, USA.
Case Reports in Nephrology and Dialysis
|October 30, 2023
Summary
Catheter-related bloodstream infections in end-stage renal disease patients with severe vascular disease can be effectively treated by converting from intermittent hemodialysis to peritoneal dialysis. This approach resolves persistent bacteremia and improves uremic symptoms.
Area of Science:
- Nephrology
- Infectious Diseases
- Vascular Surgery
Background:
- Catheter-related bloodstream infections (CRBSI) are severe complications in end-stage renal disease (ESRD) patients with central venous catheters (CVC).
- Metastatic infections often preclude catheter salvage, posing challenges for renal replacement therapy in patients with limited vascular access due to severe vasculopathy.
- Preserving existing vascular access is critical in ESRD patients with advanced vascular disease.
Observation:
- A case of an ESRD patient with advanced vascular disease presented with metastatic CRBSI and worsening uremia.
- Catheter salvage was ineffective due to metastatic infection.
Findings:
- Conversion from intermittent hemodialysis (IHD) to peritoneal dialysis (PD) was successfully implemented.
- This strategy minimized intravascular procedures and resolved persistent bacteremia.
- The patient showed a steady improvement in their uremic state following the conversion.
Implications:
- Peritoneal dialysis can be a viable alternative to IHD for ESRD patients with persistent bacteremia and metastatic CRBSI, especially those with severe vasculopathy.
- This approach offers a way to interrupt the cycle of infection and uremia in challenging patient populations.
- Further research into PD as a treatment for complex CRBSI cases in ESRD patients is warranted.
Related Concept Videos
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
26
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...
26
01:30Peritoneal Dialysis I: Introduction and Procedure
37
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...
37
01:25Peritoneal Dialysis III: Nursing Management
30
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...
30
01:24Hemodialysis II: Procedure and Complications
27
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,...
27
01:25Hemodialysis I: Introduction
36
Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
36
01:30Continuous Renal Replacement Therapy
38
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
38