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Preventing Peritonitis During Dialysis

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For many dialysis patients, one of the most unpleasant aspects of at-home dialysis is the risk of infections. When the proper precautions aren't taken, even temporarily, the oversight can cause peritonitis. According to the Centers for Disease Control and Prevention, peritonitis occurs when bacteria is allowed to invade the peritoneal cavity. Often this is caused by contaminants within the PD catheter tubing but other areas of concern include:

  1. exit site infection bacteria
  2. previously existing bacteria within the intestinal tract or stomach
  3. bacteria transferred between the caretaker and patient through non-sterile objects
  4. bacteria-laden tears in the catheter or transfer set

If contamination is suspected, the first step is to notify your health care professional for further assessment. Though not all contaminated elements cause peritonitis, antibiotics may be prescribed and catheter repair or transfer set changes may be required. Signs of the presence of peritonitis include:

  1. abdominal pain
  2. cloudy PD solution (upon draining)
  3. fever
  4. nausea and diarrhea

Preventing peritonitis and other infections require diligence on the part of both the patient and the caretaker. New catheter placement requires that the patient refrain from showers, baths and dressing changes for at least one week, leaving the abdomen and exit site dry. The catheter must be taped down securely as to not pull at the exit site, causing it to become irritated, increasing the risk of infection. 

An approved disinfectant should be used to clean the exit site on a daily basis. Your PD nurse should give you complete instructions for cleaning and disinfecting the catheter exit site. 

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