Peritoneal dialysis can lead to the following problems:

• infection
• fluid and dextrose absorption

Infection

The most common problem with peritoneal dialysis is peritonitis, a serious abdominal infection. This infection can occur if your exit site becomes infected or if the catheter becomes contaminated as you connect or disconnect it from the bags. Doctors treat peritonitis with antibiotics, which are added to the dialysis solution that you can usually take at home.

Your health care team will show you how to keep your catheter clean to prevent peritonitis. Newer catheters protect against the spread of bacteria; however, peritonitis is still a common problem that sometimes makes continuing peritoneal dialysis impossible. You should follow your health care team’s instructions carefully. Here are some general rules:

• Store your supplies in a cool, clean, dry place.

• Inspect each bag of solution for signs of contamination, such as cloudiness, before you use the solution.

• Find a clean, dry, well-lit space to perform your exchanges.

• Wash your hands every time you need to handle your catheter.

• Clean your skin where your catheter enters your body, as instructed by your health care team, every day.

• Wear a surgical mask when performing exchanges.

Report these signs of infection to your doctor immediately so he or she can treat peritonitis quickly to prevent additional problems:

• abdominal pain

• fever

• nausea or vomiting

• redness or pain around your catheter

• unusual color or cloudiness in used dialysis solution

• a catheter cuff that pushes out of your body

Fluid and Dextrose Absorption

When dialysis solution stays in the body too long, it becomes so full of wastes and extra fluid that it cannot absorb any more from the body. The process may even reverse, letting some wastes and extra fluid back into the body. The body also absorbs dextrose from the dialysis solution, which can cause weight gain because dextrose contains calories.

With continuous ambulatory peritoneal dialysis, you might have a problem with the long overnight dwell time. If your body absorbs too much fluid and dextrose overnight, you may be able to use a minicycler to exchange your solution once while you sleep. This extra exchange will shorten your dwell time, keep your body from absorbing too much fluid and dextrose, and filter more wastes and extra fluid from your body.

With automated peritoneal dialysis, you may absorb too much solution during the daytime exchange, which has a long dwell time. You may need an extra exchange in the midafternoon to keep your body from absorbing too much solution and remove more wastes and extra fluid from your body.