Most common complication of peritoneal dialysis?

PGIMER Chandigarh NO - 2015

Medical Surgical Nursing

Easy

Appeared in: PGIMER Chandigarh NO - 2015

Explanation

Peritonitis, an infection of the peritoneal membrane, is the most frequent and serious complication of peritoneal dialysis (PD).
The primary cause is a break in sterile technique during the dialysis exchange procedure, allowing skin bacteria (most commonly Staphylococcus) to enter the peritoneal cavity via the catheter.
The classic sign of peritonitis is cloudy dialysate effluent, which contains an elevated number of white blood cells.
Other symptoms include abdominal pain, fever, nausea, and vomiting.
Peritonitis is a major reason for hospitalization, catheter removal, and switching patients from PD to hemodialysis.

Option B: Abdominal pain is a common symptom of peritonitis, but it is not the complication itself. It can also be caused by other, less serious issues like rapid dialysate infusion, constipation, or catheter placement.
Option C: Abdominal distension can occur, often due to problems with draining the dialysate (outflow failure) or constipation. However, it is not as common as peritonitis.
Option D: Gastrointestinal (GI) bleeding is a rare complication of peritoneal dialysis and is not considered a common issue.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of Peritoneal Dialysis as background academic context rather than a clinical decision trigger.
A nurse's primary role is patient education on maintaining strict aseptic technique during every PD exchange to prevent peritonitis. This includes hand hygiene, wearing a mask, and proper connection/disconnection procedures.
Early recognition of peritonitis is critical. Nurses must teach patients to monitor for cloudy effluent, abdominal pain, and fever, and to report these signs immediately.
Prompt treatment with antibiotics (often administered directly into the dialysate) is essential to prevent serious outcomes like sepsis, catheter loss, and permanent damage to the peritoneal membrane.

How to Approach the Question

First, identify the core of the question: it asks for the 'most common' complication of a specific procedure, peritoneal dialysis.
Recall the nature of peritoneal dialysis: it involves a permanent catheter creating a connection between the outside environment and the sterile peritoneal cavity.
Consider the options in light of this. An indwelling catheter is a major risk factor for infection. Therefore, peritonitis (infection of the peritoneum) is a highly likely candidate.
Evaluate the other options. Abdominal pain is a symptom, not a primary complication. Abdominal distension and GI bleeding are possible but less frequent than infection.
Conclude that peritonitis is the most logical and well-known major complication associated with the long-term use of a peritoneal catheter.

Concept Tested & Keywords

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