Peritoneal Dialysis: Infections

Peritoneal dialysis (PD) is a well-established form of renal replacement therapy for patients with end-stage kidney disease (ESKD), which accounts for 11% of dialysis therapy for patients with ESKD worldwide. This chapter discusses the evidence for supporting practices in the prevention and treatment of PD related infections, particularly focus on peritonitis. Tunnel infection is defined as the presence of signs of inflammation or ultrasonographic evidence of collection along the subcutaneous catheter tunnel. Catheter exit sites can be colonized with bacteria shortly after catheter placement. Biofilm formation following colonization of bacteria can promote bacterial growth and protect them from topical antimicrobial agents. Topical disinfectants have been routinely used to clean the catheter exit site to reduce colonization around the catheter exit site in PD patients. Fungal peritonitis is usually preceded by bacterial peritonitis.