Noninfectious Complications of Peritoneal Dialysis

Abstract

Peritoneal dialysis (PD) is an established modality of kidney replacement therapy. It confers similar patient survival relative to hemodialysis (HD) and has important advantages over conventional in-center HD. However, it is associated with a collection of complications exclusive to the treatment. Apart from infectious complications including PD-related peritonitis and catheter-related infections, there are various noninfectious complications related to a dysfunctional catheter, increased intra-abdominal pressure and defects of the peritoneal cavity boundary, and bioincompatible dialysate. These complications exert adverse impact on quality of life, usually requiring interventions including surgical operation, increase the risk of PD technique failure, and sometimes can be life-threatening. This chapter focuses on the most commonly seen noninfectious complications that are unique to PD, including PD catheter malfunction, inflow and drain pain, hernia, dialysate leak, hydrothorax, hemoperitoneum, chyloperitoneum, and encapsulating peritoneal sclerosis. The authors will attempt to address the etiology, diagnosis, and management of these complications.