What is the most common complication of peritoneal dialysis?

Appeared in: SGPGI Nursing Officer-2024

Explanation

Peritonitis, an inflammation of the peritoneum, is the most common and serious complication of peritoneal dialysis.
It is typically caused by microorganisms entering the abdominal cavity through the catheter site due to a break in sterile technique during dialysate exchanges.
The earliest and most reliable sign of peritonitis is cloudy or opaque dialysate effluent, often accompanied by abdominal pain and fever.

Option A: Deep Vein Thrombosis is a blood clot in a deep vein and is not a direct complication of the peritoneal dialysis procedure itself.
Option C: Peritoneal dialysis is a treatment that removes excess fluid and waste, which typically helps to lower and control blood pressure, not cause hypertension.
Option D: Polyuria is excessive urination. Patients requiring dialysis have end-stage renal disease, characterized by minimal (oliguria) or no (anuria) urine output.

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.
Strict adherence to aseptic technique during all PD exchanges is the most critical nursing intervention to prevent peritonitis.
Patient and family education on recognizing early signs of peritonitis (cloudy fluid, pain, fever) is vital for prompt treatment and preventing hospitalization or catheter loss.
What if? If a patient reports abdominal pain but the effluent is clear, the nurse should still assess for other causes like constipation, catheter malposition, or exit-site infection, as these are also common issues in PD patients.

How to Approach the Question

First, identify the core of the question, which asks for the 'most common complication' of a specific procedure: 'peritoneal dialysis'.
This is a factual recall question. Access your knowledge about renal replacement therapies.
Consider the nature of peritoneal dialysis: it involves a permanent catheter into the abdomen and regular fluid exchanges, creating a direct portal for infection.
Evaluate the options. Peritonitis is an infection of the peritoneum, a direct and well-known risk of this procedure.
Eliminate the other options. DVT is a clotting issue, hypertension is often treated by dialysis, and polyuria is the opposite of the renal failure state.
Conclude that peritonitis is the most logical and common complication among the choices.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 2 p. 305-307

Practise the full SGPGI Nursing Officer-2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.