medical complications of peritoneal dialysis

Last reviewed 01/2018

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