Prevention and management of peritonitis and exit-site infection in patients on continuous ambulatory peritoneal dialysis.

Peritoneal dialysis (PD) is an important and lifesaving form of renal replacement therapy for more than 100 000 patients worldwide. Peritonitis, catheter exitsite, and tunnel infections are serious problems in PD patients. Peritonitis accounts for 15–35% of hospital admissions, is the major cause (40– 45%) of transfer to haemodialysis (technique failure), and finally is associated with mortality (7–10% of deaths) either as a primary or contributing factor w1x. In the early 1980s peritonitis incidence was high, with rates as high as 6.3 episodes per patient year. During the 1980s and early 1990s the peritonitis rate dropped to 1.1–1.3 episodes per patient year. With improvements in connection technology (introduction of Y-set and double-bag systems) the peritonitis rates declined further to around 0.5 episodes per patient year w2x.