Updates on Infectious and Other Complications in Peritoneal Dialysis: Core Curriculum 2023

Am J Kidney Dis. 2023 Oct;82(4):481-490. doi: 10.1053/j.ajkd.2023.03.011. Epub 2023 Jul 12.

Abstract

The last few years have seen several developments in the field of peritoneal dialysis (PD), including successful use of acute PD, increasing emphasis on home dialysis utilization, and improved understanding of models of peritoneal solute transfer. This installment of AJKD's Core Curriculum in Nephrology emphasizes the latest data available for prevention and management of infectious and noninfectious complications of PD. Through case vignettes, appropriate strategies for diagnosis and care of patients with PD peritonitis are reviewed as well as noninfectious complications evident in clinical practice including complications from increased intra-abdominal pressure, namely pericatheter and abdominal leaks, hernia formation, and complications from pleuroperitoneal communication (hydrothorax). Although rates of incisional hernias and pericatheter leaks have decreased with improved peritoneal dialysis catheter insertion techniques, these mechanical complications continue to be common occurrences and are reviewed via pertinent clinical vignettes which aim to address and discuss common implications of these scenarios. Finally, this Core Curriculum article covers a practical overview of peritoneal dialysis catheter dysfunction.

Keywords: Abdominal leak; catheter; home dialysis; hydrothorax; infection; pericatheter leak; peritoneal dialysis.

Publication types

  • Review

MeSH terms

  • Catheterization / adverse effects
  • Catheterization / methods
  • Humans
  • Kidney Failure, Chronic* / complications
  • Peritoneal Dialysis* / adverse effects
  • Peritoneal Dialysis* / methods
  • Peritonitis* / epidemiology
  • Peritonitis* / etiology
  • Peritonitis* / prevention & control