Rescue plan for CAPD peritonitis: Using ultrasonography as a guide on when to remove the catheter

Ther Apher Dial. 2023 Dec;27(6):1113-1124. doi: 10.1111/1744-9987.14042. Epub 2023 Aug 26.

Abstract

Introduction: Ultrasound has been found to facilitate early identification of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).

Methods: A retrospective analysis was carried out to evaluate the effectiveness of ultrasonography-guided removal of the Tenckhoff catheter in reducing complications like a shift to hemodialysis or death in CAPD patients.

Results: The "peritonitis rescue plan" supported timely decision-making for the removal of the infected catheter and resulted in a lower peritonitis episode per patient per month ratio (from 1:36 to 1:122) in 2021, a lower death rate (from 19% to 6.6%) and lower incidences of shifts to hemodialysis (from 2%-9% to 0%) as compared to that before the implementation of the plan in 2019.

Conclusion: The implementation of the "peritonitis rescue plan" and the removal of the infected catheter within 3 days of peritonitis being detected was successful in improving the standard of care for patients undergoing CAPD.

Keywords: Tenckhoff catheter; continuous ambulatory-related peritonitis; peritoneal dialysis; peritonitis rescue plan; ultrasonography-guided volume assessment and peritonitis.

MeSH terms

  • Catheters, Indwelling / adverse effects
  • Humans
  • Peritoneal Dialysis* / adverse effects
  • Peritoneal Dialysis, Continuous Ambulatory* / adverse effects
  • Peritoneal Dialysis, Continuous Ambulatory* / methods
  • Peritonitis* / diagnostic imaging
  • Peritonitis* / epidemiology
  • Peritonitis* / etiology
  • Retrospective Studies

Grants and funding