Swimming on Peritoneal Dialysis: Recommendations from Australian PD Units

Abstract

Background There is no evidence to support the need for protection of the peritoneal dialysis (PD) catheter and exit site for people on PD who want to swim. Swimming with a PD catheter is perceived to potentially put that person at increased risk of infection. Objectives of this study were to determine the proportion of Australian PD units supporting swimming for people on PD, recommendations made to protect the PD catheter, and exit site and any subsequent infective complications. Method Phone surveys were conducted with PD nurses from a cross section of 39 Australian PD units. Results Almost all units reported that patients on PD do swim despite only 77% of units advocating swimming. Swimming in sea water (85%) or a private swimming pool (90%) is mostly recommended. Covering the exit site and PD catheter is recommended with a waterproof film dressing or colostomy bag. Performing routine exit-site care after swimming is recommended (100%). There were 7 reported exit-site infections and 2 episodes of peritonitis perceived to be associated with swimming with a PD catheter. Conclusion Most PD units in Australia report that patients on PD swim. Swimming is recommended in either sea water or private swimming pools. The PD catheter and exit site should be covered with either a clear waterproof dressing or colostomy bag. Routine exit-site care should be performed after swimming. Infections were rarely reported in those who swim. Until further research is available, best practice recommendations are warranted for the safety of those on PD who want to swim.

Physical activity and exercise in peritoneal dialysis: International Society for Peritoneal Dialysis and the Global Renal Exercise Network practice recommendations

“…Exit site infections or peritonitis are rarely reported in those who swim. 24 It is a common practice to have appropriate protection for the catheter and exit site during bathing or swimming. 25 European PD centres allow bathing, swimming and saunas.…”

“…27 85% of Australian PD nurses recommend swimming is safe in private pools with 90% recommending safety in sea water as long as protocols are adhered to. 24 Swimming can be safe in lakes and public pools if strict pre-and post-exit site care are adhered to. 28…”

“…85% of Australian PD nurses recommend swimming is safe in private pools with 90% recommending safety in sea water as long as protocols are adhered to. 24…”

Reducing and treating peritoneal dialysis catheter-related infections: Nursing implementation from evidence to practice

“…A recent survey of nurses from 39 home PD units in Australia found that, in general, almost all units reported that patients on PD do swim despite only 77% of units advocating swimming. 8 The recently published ISPD practice recommendations on physical activity and exercise for PD patients, cited in these latest ISPD PD Catheter-related Infection Guidelines, do give helpful suggestions along with important practice points on swimming for a patient on PD. 9 These recommendations advise that swimming should preferably take place in either seawater or swimming pools that are known to be well maintained (private or municipal) to limit exposure to waterborne pathogens; a transparent waterproof dressing or a colostomy bag to cover the PD catheter and exit site; and routine PD catheter exit-site care after swimming.…”

A Broad Canvas—From Math to Swimming… and Farewell to Multimed

“…A phone survey about swimming conducted with nurses from Australian PD units provides practical information for patients and teams (2). The majority of units recommend swimming for people on PD as long as the PD catheter and exit site are covered with a waterproof-type dressing.…”