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Review
. 2018 Jun 11:11:173-186.
doi: 10.2147/IJNRD.S123618. eCollection 2018.

Peritoneal dialysis-related peritonitis: challenges and solutions

William L Salzer  1
Affiliations
Review

Peritoneal dialysis-related peritonitis: challenges and solutions

William L Salzer. Int J Nephrol Renovasc Dis. .

Abstract

Peritoneal dialysis is an effective treatment modality for patients with end-stage renal disease. The relative use of peritoneal dialysis versus hemodialysis varies widely by country. Data from a 2004 survey reports the percentage of patients with end-stage renal disease treated with peritoneal dialysis to be 5%-10% in economically developed regions like the US and Western Europe to as much as 75% in Mexico. This disparity is probably related to the availability and access to hemodialysis, or in some cases patient preference for peritoneal over hemodialysis. Peritoneal dialysis-related peritonitis remains the major complication and primary challenge to the long-term success of peritoneal dialysis. Fifty years ago, with the advent of the Tenckhoff catheter, patients averaged six episodes of peritonitis per year on peritoneal dialysis. In 2016, the International Society for Peritoneal Dialysis proposed a benchmark of 0.5 episodes of peritonitis per year or one episode every 2 years. Despite the marked reduction in peritonitis over time, peritonitis for the individual patient is problematic. The mortality for an episode of peritonitis is 5% and is a cofactor for mortality in another 16% of affected patients. Prevention of peritonitis and prompt and appropriate management of peritonitis is essential for the long-term success of peritoneal dialysis in all patients. In this review, challenges and solutions are addressed regarding the pathogenesis, clinical features, diagnosis, treatment, and prevention of peritoneal dialysis-related peritonitis from the viewpoint of an infectious disease physician.

Keywords: peritoneal dialysis; related peritonitis.

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Conflict of interest statement

Disclosure The author reports no conflicts of interest in this work.

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References

    1. Grassmann A, Gioberges S, Moeller S, Brown G. ESRD patients in 2004: global overview of patient numbers, treatment modalities and associated trends. Nephrol Dial Transplant. 2005;20:2587–2593. - PubMed
    1. Li PK, Szeto CC, Piraino B, et al. ISPD peritonitis recommendations: 2016 update on prevention and treatment. Perit Dial Int. 2016;36:481–508. - PMC - PubMed
    1. Mujais S. Microbiology and outcomes of peritonitis in North America. Kidney Int. 2006;70:S55–S62. - PubMed
    1. Ghali JR, Bannister KM, Brown FG, et al. Microbiology and outcomes of peritonitis in Australian peritoneal dialysis patients. Perit Dial Int. 2011;31:651–662. - PubMed
    1. van Duepen AT, Tomlinson GA, Jassal SV. The association between exit site infection and subsequent peritonitis among peritoneal dialysis patients. Clin J Am Soc Nephrol. 2012;7:1266–1271. - PMC - PubMed

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