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Medical complications of peritoneal dialysis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

These include

  • peritonitis:
    • usually due to poor technique
    • routinely culture the drained dialysate
    • instill suitable antibiotics if suspected - suitable blind treatment would be vancomycin plus gentamicin, or ceftazidime

  • hypovolaemia:
    • usually caused by too rapid ultrafiltration - osmolarity of dialysate is too high
    • avoid by regularly monitoring weight and blood pressure
    • increase intravascular volume with parenteral saline or plasma

  • electrolyte disturbance:
    • set dialysate composition accordingly

  • weight gain, hypertriglyceridaemia and hyperglycaemia:
    • due to glucose loading from dialysate
    • give small doses of subcutaneous insulin for hyperglycaemia

  • protein and amino acid losses:
    • provide patient with a high protein diet
    • limit duration of dialysis to maximum of 72 hrs weekly
    • consider haemodialysis if reduced period of peritoneal dialysis inadequate

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