Peritoneal Dialysis Complications

Peritoneal dialysis (PD) uses the peritoneal membrane as a semipermeable dialysis surface. Dialysate enters the peritoneal cavity through a catheter, remains there for a prescribed dwell, and is then drained. Complications therefore fall into recognizable patterns: infection within the cavity or around the catheter, mechanical problems caused by pressure or catheter position, metabolic effects of dialysate exposure, and long-term injury to the peritoneal membrane. The complication that demands the fastest response is suspected peritonitis. Cloudy effluent is not a benign variation in drainage. Until proven otherwise, it represents peritoneal infection. Abdominal pain, fever, nausea, or malaise strengthen the suspicion, but their absence does not safely exclude it. A useful clinical question is: What changed—the effluent, the catheter, the patient's breathing, or the patient's systemic state? That question helps separate peritonitis from a leak, constipation-related drainage failure, hydrothorax, or a noninfectious effluent abnormality.