Peritonitis in peritoneal dialysis.
Peritonitis, an infectious complication of peritoneal dialysis, continues to account for much of the morbidity associated with this techniques. The clinical presentation and laboratory data used in diagnosis the peritonitis, as well as its differential diagnosis will be reviewed in this article. The distribution of pathogens is an important outcome determinant, Gram-negative infections being associated with greater rates of catheter loss and higher death rates. Among the five routes of peritoneal contamination, intraluminal and periluminal contamination account for most of the infections. Due to the two prevention methods implemented in the care of the PD population, the incidence of peritonitis has decreased over the last two decades. The recommendations for empiric treatment of peritonitis have changed over the years, as more was learnt about antibiotic resistance and drug toxicity. Future research to address enteric peritonitis, as well as biocompatible dialysis solution or biocompatible catheter materials is needed to further reduce the incidence of PD peritonitis.
Voinescu
C G
CG
Department of Internal Medicine, University Hospital & Clinics, Columbia, Missouri 65212, USA. voinescuc@health.missouri.edu
Khanna
R
R
D003937:Diagnosis, Differential; D006801:Humans; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy