Complications during Peritoneal Dialysis
The major complications of peritoneal dialysis are peritonitis, catheter-associated nonperitonitis infections, weight gain a disturbances, and residual uremia (especially among patients with no residual kidney function).
Peritonitis typically develops when there has been a break in sterile technique during one or more of the exchange proc defined by an elevated peritoneal fluid leukocyte count (100/mm3, of which at least 50% are polymorphonuclear neutro presentation typically consists of pain and cloudy dialysate, often with fever and other constitutional symptoms. The mo organisms are gram-positive cocci, including Staphylococcus, reflecting the origin from the skin. Gram-negative rod infe fungal and mycobacterial infections can be seen in selected patients, particularly after antibacterial therapy. Most cases managed either with intraperitoneal or oral antibiotics, depending on the organism; many patients with peritonitis do no cases where peritonitis is due to hydrophilic gram negative rods (e.g., Pseudomonas sp.) or yeast, antimicrobial therapy and catheter removal is required to ensure complete eradication of infection. Nonperitonitis catheter-associated infection infections) vary widely in severity. Some cases can be managed with local antibiotic or silver nitrate administration, whi enough to require parenteral antibiotic therapy and catheter removal.
Peritoneal dialysis is associated with a variety of metabolic complications. As noted above, albumin and other proteins c peritoneal membrane in concert with the loss of metabolic wastes. The hypoproteinemia induced by peritoneal dialysis o protein intake in order to maintain nitrogen balance. Hyperglycemia and weight gain are also common complications of hundred calories in the form of dextrose are absorbed each day, depending on the concentration employed. Peritoneal d those with type II diabetes mellitus, are then prone to other complications of insulin resistance, including hypertriglycer side, the continuous nature of peritoneal dialysis usually allows for a more liberal diet, due to continuous removal of pot two major dietary components whose accumulation can be hazardous in ESRD.
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