Diagnosis Process and Medicine for Peritonitis In Dialysis
Peritoneal Dialysis (PD) is the main kidney replacement therapy for end stage renal disease (ESRD). in recent years, with the improvement and development of PD technology and management quality, the survival time and quality of life of PD patients are constantly improved but peritonitis is still a common and serious complication in PD patients. Peritonitis is the main reason for failure of PD technology and patients for long time of dialysis. Severe and prolonged peritonitis can lead to structural and functional changes in the peritoneum, which can eventually lead to peritoneal failure and even death. The correct and timely diagnosis and treatment of peritonitis is helpful for the early cure of peritonitis and the recovery of peritoneal function.
Causes of peritonitis from PD
Many causes can induce PD-related peritonitis. Causes are different and pathogenic microorganism are different as well. For example, peritonitis caused by staphylococcus aureus and pseudomonas aeruginosa is usually secondary to exit-site and tunnel infections caused by homogenous microorganisms. Peritonitis caused by coagulase negative staphylococcus is usually associated with contamination of the connecting catheter operation or the pipeline.
Diagnosis for PD-related peritonitis
Patients with peritonitis usually present with cloudy effluent and abdominal pain. The guidelines recommend that in PD patients with opacification of peritoneal dialysis fluid (peritoneal fluid), peritonitis should be considered and treated as peritonitis until the diagnosis of peritonitis is clear or excluded. As long as peritonitis is suspected, PD effluent should be sent for white blood cell count, classification, gram smear staining and bacterial culture.
Treatment for PD-related peritonitis
Once the diagnosis of peritonitis is made, empirical antibiotic treatment is recommended to start as soon as possible after proper retention of microbiological specimens
Administration route and dose of antibiotics
Intraperitoneal administration is the preferred administration route of antibiotics unless patients have signs of systemic sepsis. In general, intraperitoneal administration results in a higher concentration of intraperitoneal drugs and is superior to intravenous administration. And intraperitoneal medication avoids venipuncture, allowing patients to operate at home after appropriate training.
Follow-up treatment of peritonitis
Within 48 hours of initial treatment, most patients with PD-associated peritonitis will show significant improvement in clinical symptoms. PD effluents should be checked daily for clarity. If there is no improvement after 48h, the ascites cell count and bacterial culture should be done again. Monitoring the white blood cell count of the dialysate can predict the treatment response. Once the results of germiculture and sensitivity are known, antibiotics should be adjusted to the appropriate narrow-spectrum antibiotics.
For refractory peritonitis, recurrent peritonitis and fungal peritonitis, the peritoneal dialysis catheter should be removed unless there is clinical contraindication. It is feasible for many patients who remove the catheter with refractory peritonitis, recurrent peritonitis and fungal peritonitis to consider returning to PD treatment after infection control. About more information, you can leave a message below or consult our online doctor directly. We will reply you as soon as possible.
***Please seek professional medical advise for the diagnosis or treatment of any ailment, disease or medical condition. This article is not intended to be a substitute for the advice of a licensed medical professional.***