Peritoneal Dialysis and Infection Prevention

For Health Care Providers

Key points

  • Peritoneal dialysis (PD) is a treatment used to manage kidney failure. PD uses the peritoneal membrane to remove waste products and excess fluid from the body.
  • Infections related to PD often affect the peritoneal membrane (peritonitis) or the catheter exit site (exit-site infection).
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Overview

Peritoneal dialysis (PD) is a treatment used to manage kidney failure. PD uses the peritoneal membrane, the lining of the abdominal cavity, to remove waste products and excess fluid from the body. It is often performed in home settings and requires placement of a catheter (a soft, flexible tube) in the abdomen. Dialysis care teams provide training and support for patients performing PD at home. In 2023, nearly 68,000 people in the United States were receiving PD.1

Preventing infections

Infection prevention is a key component of PD care. Because PD requires ongoing access to the peritoneal cavity through a catheter, there is a risk of introducing pathogens during exchanges and catheter handling. Early recognition of infections may help reduce complications and improve patient outcomes.

Prevention efforts focus on minimizing contamination and maintaining catheter site integrity. These efforts may include:

  • Hand hygiene before catheter or supply handling
  • Use of aseptic technique during exchanges
  • Routine care of the catheter exit site
  • Training on PD procedures and infection prevention practices

Dialysis care teams support infection prevention through patient training and ongoing monitoring.

Common infections

Infections related to peritoneal dialysis most often affect the peritoneal membrane (peritonitis) or the catheter exit site (exit-site infection).

Peritonitis

Common signs and symptoms of peritonitis may include:

  • Cloudy dialysis effluent (drained dialysis fluid)
  • Abdominal pain or tenderness
  • Fever or chills

Exit-site infection

Common signs and symptoms may include:

  • Redness or swelling at the site
  • Pain or tenderness around the site
  • Drainage from the site

New symptoms or changes in the appearance of dialysis effluent may indicate infection and warrant further evaluation. Patients with suspected infection require prompt clinical evaluation and treatment.

Clinical resources

Refer to the clinical resources below to help prevent infections related to PD:

Spotlight

Core Interventions for the Prevention of Peritoneal Dialysis (PD)-Related Infections - ASN Excellence in Patient Care (EPC)

The American Society of Nephrology developed core interventions to help prevent infections related to PD. These interventions provide a framework for dialysis facilities and are based on current evidence and clinical practice guidelines.

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Content Source:
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
  1. United States Renal Data System. 2025 USRDS Annual Data Report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2025. Available at: https://usrds-adr.niddk.nih.gov/2025/end-stage-renal-disease/1-incidence-and-prevalence