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Peritonitis - dialysis associated

Definition

Dialysis-associated peritonitis is inflammation of the lining of the abdominal cavity (peritoneum) that occurs in someone who receives peritoneal dialysis.

Alternative Names

Dialysis-associated peritonitis

Causes

Dialysis-associated peritonitis may be caused by bacteria that get into the area during the dialysis procedure. Skin bacteria or fungi can cause the infection.

Symptoms

• Abdominal tenderness
• Distended abdomen
• Nausea and vomiting

Other symptoms that can occur with this disease:

• Chills
• Fever

Exams and Tests

The doctor will do a physical examination and may find that your abdomen is tender when touched. There may be some discharge from the site where the catheter used for dialysis enters the skin. Dialysis fluid may be cloudy.

Tests that can show infection include:

• Blood culture
• Complete blood count (CBC)
• Peritoneal fluid culture, cell count and gram stain

Treatment

The goal of treatment is to cure the infection. Antibiotics are given into a vein (intravenous injection) or into the lining of the abdomen (peritoneum).

Laboratory tests that show which bacteria or fungi are causing the infection will determine the type of antibiotic used.

Outlook (Prognosis)

Most patients recover.

Possible Complications

• Intraabdominal abscess
• Peritonitis that returns after treatment

You may need to have the dialysis catheter removed.

When to Contact a Medical Professional

Call your health care provider if you receive peritoneal dialysis treatments and develop symptoms of peritonitis.

Prevention

Careful sterile technique when performing peritoneal dialysis may help reduce the risk of inadvertently introducing bacteria during the procedure. Some cases are not preventable. Equipment design improvements have made these infections less common.

References

Sharma A, Blake PG. Peritoneal Dialysis. In: Brenner BM, ed. Brenner and Rector's The Kidney. 8th ed. Philadelphia, Pa; Saunders Elsevier; 2007: chap 59.

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