Complications of Continuous Ambulatory Peritoneal Dialysis

Abstract

Continuous ambulatory peritoneal dialysis (CAPD) is used to treat end-stage renal failure in an increasing number of patients. CAPD has an advantage over hemodialysis in that it allows patients greater freedom to perform daily activities; it also provides other clinical benefits. However, the long-term effectiveness of CAPD is limited by complications, which have various causes. Complications with an infectious cause include bacterial peritonitis, tuberculous peritonitis, and infections of the catheter exit site and tunnel. Noninfectious complications include catheter dysfunction, dialysate leakage, hernias, and sclerosing encapsulating peritonitis. Many imaging modalities-radiography, ultrasonography, peritoneal scintigraphy, computed tomography (CT), and magnetic resonance (MR) imaging-are useful for characterizing these complications. CT peritoneography and MR peritoneography are techniques specifically suited to this purpose. Imaging plays a critical role in ensuring that complications are detected early and managed appropriately.

Consensus Guidelines for the Prevention and Treatment of Catheter-Related Infections and Peritonitis in Pediatric Patients Receiving Peritoneal Dialysis: 2012 Update

“…Although most catheter TIs can be diagnosed by clinical exam alone, ultrasonographic examination of the catheter tunnel may be helpful in detecting a clinically occult TI, in delineating the extent of the infection, and in evaluating response to antibiotic therapy (142,(283)(284)(285).…”

“…Empiric therapy is therefore often indicated, with modification subsequent to receipt of culture and susceptibility results. Sonographic examination may help in the evaluation of the extent of infection along the tunnel and the likely efficacy of antibiotic therapy (142,(284)(285)(286). Catheter removal and replacement is often required when continued medical management appears futile.…”

Peritonectomy Treatment for Recurrent Sclerosing Encapsulated Peritonitis Attacks: Case Report

“…While peritoneal dialysis is a comfortable treatment option for end-stage renal failure patients, continuous use and irregular care can cause risk of contamination and bacterial translocation and subsequently 0.9-7.3% risk of sclerosing encapsulated peritonitis. 8 The clinic of sclerosing encapsulated peritonitis, according to the classification made by Kawanishi et al, is divided into four phases: peritonitis phase, inflammatory phase, progressive phase, and fibrotic phase. 9 Symptoms are generally nonspecific obstruction symptoms (nausea, vomiting, abdominal pain), and patients are often admitted to the hospital in peritonitis phase or inflammatory phase.…”

Is There Need of an Extension Channel/New Double-Cuffed Channel in Surgical Management for Channel Perforation and Aneurysm of Tenckhoff Catheter?: Modified Partial Replantation

“…Despite the obvious benefits of peritoneal dialysis (PD) there are a number of associated complications, the most common being exit-site infection and peritonitis (1,2). Permanent and safe access to the peritoneal cavity is fundamental for the success of PD.…”