Peritonitis is a common and serious complication of peritoneal dialysis pd. Effective treatment of pd peritonitis american society. Management of peritoneal dialysisassociated peritonitis. In addition, severe or prolonged peritonitis leads to structural and functional alterations of the peritoneal membrane, eventually leading to membrane failure. Treatment of peritoneal dialysis associated fungal peritonitis. Although less than 5% of peritonitis episodes result in death, peritonitis is the direct or major contributing cause of death in around 16% of pd patients 16. Peritoneal dialysis pdrelated infection encompasses pdrelated peritonitis and catheterrelated infections, and the latter is used as the collective term to describe exit site infection esi and tunnel infection. Clinical pathways never replace clinical judgement. The patient uses their peritoneum as a dialysis membrane in conjunction with a surgically placed dialysis catheter that penetrates the abdominal wall.
This has lead to an increase in patients who have to start in a peritoneal dialysis program, mainly in emerging nations. Fish, 6 eric goffin, 7 yonglim kim, 8 william salzer, 9 dirk g. Recommendations for the treatment and prevention of pdrelated peritonitis, and latter those for catheterrelated infections, under the auspices of the international society for peritoneal dialysis ispd were first published in 1987 and revised in 1989, 1993, 1996, 2000, 2005, and 2010 1,2,3,4,5,6,7,8. Approximately 20% of peritonitis episodes require cessation of pd and transfer to haemodialysis, although this figure varies depending on the. Peritonitis has been the plague of patients on peritoneal dialysis pd since its inception. A 58yearold woman with type 2 diabetes, diabetic nephropathy, and esrd has been undergoing treatment with automated peritoneal dialysis for the last 2 years four exchanges overnight using a cycler over 9 hours with a singleday dwell with icodextrin, and she presented to the emergency department with severe abdominal pain and cloudy dialysate. Recomendations ispd peritoneal dialysis international. Consensus guidelines for the treatment of peritonitis in pediatric patients receiving peritoneal dialysis 2000 eps. Peritonitis treatment and prophylaxis february 2014 page 4 between the fluconazole and no fluconazole groups in the prevention of peritonitis in patients with fungal exitsite or tunnel infections. Peritonitis is a serious complication of peritoneal dialysis pd responsible for significant morbidity, and accounts for 22% of technique failures and 14% of infectious deaths in australian and new zealand pd patients.
Pdf peritonitis secondary to uncommon gramnegative. Peritonitis asociada a dialisis peritoneal peritoneal dialysis related peritonitis article pdf available january 2012 with 5,657 reads how we measure reads. Either at night or multiple times during the day peritoneal fluid is infused into the abdomen in an ambulatory setting or at home. Although less than 4% of peritonitis episodes result in death, peritonitis is a contributing factor to death in 16% of deaths on pd. Peritonitis is a common complication of peritoneal dialysis. This form is to be used to assess patients on peritoneal dialysis who. Peritoneal dialysis related peritonitis summary endstage renal disease in one of the main complications of some of the most prevalent chronic diseases such as type 2 diabetes mellitus and hypertension. The diagnosis of peritonitis is made according to already established criteria. Peritonitis bacteriana secundaria a dialisis peritoneal scielo. Peritonitis asociada a dialisis peritoneal medigraphic. Ispd guidelines advancing knowledge of peritoneal dialysis.
Although peritonitis can be a complication of peritoneal dialysis, its much less common than it used to be because of improved technology and selfcare techniques that are taught during initial. Peritonitis is associated with significant morbidity, catheter loss, transfer to hemodialysis, transient loss of ultrafiltration, possible permanent membrane damage, and occasionally death. Director, dialysis and transplantation the childrens mercy hospital. Treatment of peritoneal dialysis pd related peritonitis page 2 of 7 patients receiving more than one dose of gentamicin or vancomycin should have. Peritoneal dialysis outcomes after temporary haemodialysis. Patients perceptions and factors affecting dialysis modality decisions. In an early article by the pd pioneer karl nolph and coworkers 11, peritonitis was defined as cloudy effluent with 100 white cells per millimeter, of which 50% were polymorphonuclear cells. Peritonitis remains the archilles heel of peritoneal dialysis pd and is the major cause of technique failure 1,2. Peritonitis caused by pseudomonas species is a particularly common and serious complication in the asiapacific region, and is often associated with a poor response to antibiotics as well as a high rate of catheter removal 3,4. Peritonitis secundaria a dialisis en pacientes con. Selfcare peritoneal dialysis patients with cognitive impairment have a higher risk of peritonitis in the second year. Around 18% of the infectionrelated mortality in pd patients is the result of peritonitis. Peritonitis secundaria a dialisis en pacientes con insuficiencia renal cronica.
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