Definition of Peritonitis - dialysis associated:

Dialysis-associated peritonitis is inflammation of the lining of the abdominal cavity (peritoneum), which occurs in those who receive peritoneal dialysis.

Causes, incidence, and risk factors:

Dialysis-associated peritonitis may be caused the introduction of bacteria into the area during the dialysis procedure. Skin bacteria, atypical or mycobacteria, or fungi can cause the infection.

Approximately one infection occurs for every 15 months of peritoneal dialysis.

Symptoms:

• Abdominal tenderness
• Distended abdomen
• Nausea and vomiting
• Cloudy dialysis fluid

• Fever
• Chills

Signs 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.

Tests that can show infection include:

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

Treatment:

The goal of treatment is to cure the infection. Antibiotics are given into a vein (intravenous injection) or into the peritoneum. The specific antibiotic used will be determined by laboratory tests that show the exact type of organism causing the infection.

Expectations (prognosis):

Most patients recover uneventfully.

Complications:

• Recurrent peritonitis
• Intraabdominal abscess
• Catheter tract infection
• Removal of the dialysis catheter may be necessary

Calling your health care provider:

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.