If there are any signs of infection (e.g., redness, swelling, itching, sensitivity, pain, and fever) or you suspect you may be getting an infection, contact your dialysis team immediately.
It is very important that you disinfect and dress the catheter exit site before each dialysis treatment, as directed by your dialysis team. Strictly adhere to the instructions, as provided by the dialysis team, when connecting and disconnecting the dialysis catheter. Also make sure that your catheter is protected as much as possible in everyday life (during personal hygiene, housework, or gardening).
There are three types of infections in peritoneal dialysis:
- Peritonitis: an infection in the peritoneal cavity
- Exit site infection: an infection in the skin around the exit site of your PD catheter
- Tunnel infection: an infection of the catheter pathway under the skin
In most cases, these infections can be solved with the appropriate treatment especially if approached early. However, some infections can be very serious and can result in catheter removal or even having to stop peritoneal dialysis treatment. That is why early recognition and treatment with the proper dose of medication is absolutely necessary. Most of your training involves ways to prevent and recognize these three types of infections.
The primary goal of hygiene measures in PD is to prevent peritonitis, as this may require an interruption of treatment. Peritonitis is caused by organisms entering the abdominal cavity. You can prevent peritonitis by:
- Paying the utmost attention to hygiene
- Following hygiene measures taught by your nurse (this may include wearing a face mask, and practicing regular hand hygiene)
- Changing the bags according to the instructions
Despite all precautions, you may not be able to rule out the possibility of contracting peritonitis. You should contact your dialysis center immediately if you have even the slightest suspicion of an infection.
Always ensure that you work hygienically when changing dressings and bags. This includes:
- Disinfection of the workspace
- Adequate hand hygiene when performing dialysis
- Wearing a face mask
- Not having pets in the PD treatment room
- Regular dressing changes according to instructions by your healthcare team
- Body hygiene
No organisms should get into your catheter extension port. Therefore, the end of the catheter extension must not be touched under any circumstances when the protective cap is removed.
Infection of the catheter exit site or tunnel infection
There are a number of clear signs that indicate an infection of the catheter exit site:
- Pain, and
are symptoms of an infected catheter site. As soon as you notice a change at the catheter exit site, contact your dialysis center immediately.
A tunnel infection is an infection along the catheter tunnel and often occurs together with an infection at the catheter exit site. The tunnel infection may be indicated by swelling, redness, tension, or pain around the catheter tunnel.