| Theme | Controlling Infections in Dialysis Patients | |
|---|---|---|
| Title | Complications from peritoneal dialysis, peritonitis and exit site infection | |
| Publish Date | 2009/01 | |
| Author | Hidetomo Nakamoto | Department of General Internal Medicine, Saitama Medical University |
| [ Summary ] | The use of CAPD for the treatment of end-stage renal disease (ESRD) has been commonplace in Japan since 1980. Peritonitis and exit site infections are two of the most important complications in patients receiving peritoneal dialysis. There were 1.7 episodes of peritonitis and 0.7 exit site / tunnel infections observed per year. Peritonitis and exit site infections remain the main complications related to CAPD, but can be minimized by development of adequate facilities to perform CAPD. Approximately 20 % of peritonitis infections are resistant to initial therapy, which either fails to be resolved with appropriate antibiotics (refractory peritonitis) or relapse within four weeks after antibiotics are discontinued (relapsing peritonitis). Recently, the incidence of peritonitis has decreased, however the incidence of resistant peritonitis is increasing in Japan. In addition, the incidence of exit site infections has not changed in this decade. To prevent exit site infections, intensive care of exit sites is the most important factor for good peritoneal dialysis care. There are no guidelines for diagnosis and treatment of peritonitis and exit site infections in Japan. New guidelines covering peritonitis and exit site infections should be created as soon as possible. |
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