Peritoneal Dialysis Complications
Peritonitis:
 • Can't miss! 6% of cases result in death
 • Diagnostics:
    1) evidence of peritonitis on exam
    2) dialysis effluent WBC>100/uL with >50% pMNs.
    3) positive dialysis effluent culture
 • Remove catheter if: Refractory or Relapsing Peritonitis or Fungal Peritonitis
Site Infections:
 • Risk Factors: Poor Exit Site Care, Catheter Mobilitization, Swimming, Presence of pets during exchange
 • If persistent -> exchange catheter
Outflow Failure
 • Incomplete recovery of instilled fluid
 • Always evaluate for constipation
 • Also see fibrin clots and catheter malpositioning
Membrane Failure: Insufficient flow across the peritoneal membrane
Catheter-Cuff Extrusion: Erosion of the cuff through the skin 
Intestinal Perforation: Feculent/bloody dialysate, dialysate retention, diarrhea after instillation

- Dr. Taliya Lantsman @TLantsman via @iMedEducation

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