Dialysis-associated peritonitis

Alternative names
Peritonitis - dialysis associated; Continuous ambulatory peritoneal

This is an acute or chronic inflammation (irritation and swelling) of the peritoneum (lining of the abdomenal cavity) that occurs in people receiving peritoneal dialysis.

Causes, incidence, and risk factors

The cause of dialysis-associated peritonitis may be the introduction of bacteria into the peritoneum by the dialysis procedure. Skin bacteria are the most common organisms causing infection. Incidence is about one infection for every 15 months of peritoneal dialysis.


  • Abdominal tenderness  
  • Distended abdomen  
  • Nausea and vomiting  
  • Cloudy dialysis fluid

Additional symptoms that may be associated with this disease:

  • Fever  
  • Chills

Signs and tests

The doctor will do a physical examination and may find that your abdomen is tender when touched. There may be some discharge from the site where the catheter used for dialysis enters the skin.

Tests that can show infection include:

  • Peritoneal fluid culture, cell count and Gram stain  
  • CBC (complete blood count)  
  • Blood culture


The goal of treatment is to cure the infection. Antibiotics are given into a vein (intravenous injection) and/or into the peritoneum. The antibiotic will be specific to the organism recovered in cultures of blood or peritoneal fluid.

Expectations (prognosis)

Most patients recover uneventfully.


  • Recurrent peritonitis  
  • Intraabdominal abscess  
  • Catheter tract infection  
  • Removal of the dialysis catheter may be necessary

Calling your health care provider

Call your health care provider if you receive peritoneal dialysis treatments and develop symptoms of peritonitis.


Careful sterile technique when performing peritoneal dialysis may help reduce the risk of inadvertently introducing bacteria during the procedure. Some cases are not preventable. Equipment design improvements have made these infections less common.

Johns Hopkins patient information

Last revised: December 3, 2012
by Martin A. Harms, M.D.

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