From 2009 to 2019, the percentage of US patients on dialysis choosing peritoneal dialysis (PD) rose from 6.6% to 12.3%. However, about 25% of these patients switch to in-center hemodialysis within two years due to complications like peritonitis and mechanical issues. Advances in managing PD complications, especially infections like peritonitis, have reduced hospitalization rates over the past decade through improved preventive measures. PD-related infections, including exit site infections, remain a key area of focus for ongoing research and updated guidelines.

Catheter-related infections are a leading cause of PD-associated peritonitis, with treatment often requiring antibiotics tailored to culture results, commonly for Staphylococcus aureus. Case studies highlight the challenges in managing recurrent or resistant infections, sometimes necessitating catheter removal. Additionally, noninfectious issues like increased intra-abdominal pressure, hernias, and catheter malfunction are addressed with updated treatment recommendations. Improved PD care practices, including home visits and personalized training, have helped reduce these complications and improve patient outcomes.

Reference: Khan SF. Updates on Infectious and Other Complications in Peritoneal Dialysis: Core Curriculum 2023. Am J Kidney Dis. 202;82(4):481-490. doi: 10.1053/j.ajkd.2023.03.011.