Indications for Catheter Removal in a Patient with Peritoneal Dialysis-Associated Peritonitis

The decision whether to remove a peritoneal dialysis catheter in a patient with peritonitis can be difficult.

Patient selection: peritonitis associated with peritoneal dialysis

Situation	Catheter Removal
bacterial exit site and/or tunnel infection, refractory or relapsing	remove and replace immediately
bacterial peritonitis, concurrent exit site and/or tunnel infection with the same organism	remove with delayed replacement
bacterial peritonitis, refractory	remove with delayed replacement
bacterial peritonitis, relapsing	remove and replace immediately
bacterial peritonitis, repeated	possibly remove with delayed replacement
bacterial peritonitis, surgical (multiple enteric bacteria secondary to intra-abdominal abscess, diverticulitis, etc)	possibly remove with delayed replacement
fungal peritonitis	remove with delayed replacement
mycobacterial peritonitis	possibly remove with delayed replacement

where:

• Coagulase-negative Staphylococci isolated on culture may or may not be pathogenic.

• Delayed replacement is typically done after 2-3 weeks. Mycobacterial infections require 6 weeks.

• For surgical peritonitis replacement of the catheter depends on the management of the intra-abdominal process.

• A catheter replacement immediately should use a different exit site and tunnel.

To read more or access our algorithms and calculators, please log in or register.