Current management of complications and infections in peritoneal dialysis

Complications occurring during peritoneal dialysis (especially infectious complications) are still the main reason for changing the procedure. By correct preoperative planning of catheter placement, the site of implantation and the surgical approach, many potential complications occurring during the course can be reduced. Pre-existing hernias can be corrected simultaneously with catheter placement. Discoloration of the dialysate must be clarified. Catheter dysfunction can often be corrected by simple mechanical procedures and surgery is rarely necessary. The incidence of encapsulating peritoneal sclerosis (EPS), one of the most serious complications of peritoneal dialysis, is decreasing due to several measures, particularly increasing training and awareness of medical personnel. Infectious complications (exit site infections, peritonitis) have to be systematically treated and can be reduced by structured patient education performed by qualified nursing personnel.