Illustration symbolizing healthy peritoneal dialysis.

Peritoneal Dialysis and Peritonitis: Are You at Risk?

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Nico Varela in Health & Wellness December 2025 • 4 min read.

"Unveiling the Risk Factors of Peritonitis in Peritoneal Dialysis Patients"


For individuals facing end-stage renal disease (ESRD), peritoneal dialysis (PD) offers a vital lifeline, providing a home-based alternative to hemodialysis. PD allows patients to maintain a greater sense of independence and a better quality of life. Yet, like all medical treatments, it comes with potential complications, the most concerning of which is peritonitis.

Peritonitis, an inflammation of the peritoneum (the membrane lining the abdominal cavity), poses a significant threat to PD patients. It can lead to poor dialysis outcomes, membrane damage, and even PD failure, ultimately reducing a patient's quality of life. Understanding the factors that increase the risk of peritonitis is crucial for prevention and improved management.

This article translates the findings of a research study focused on identifying these risk factors in PD patients. By understanding the factors that predispose individuals to peritonitis, patients and healthcare providers can work together to minimize risk and optimize the benefits of PD therapy.

What Factors Increase Your Risk of Peritonitis During Peritoneal Dialysis?

Illustration symbolizing healthy peritoneal dialysis.

A recent study investigated the potential risk factors associated with peritonitis in 115 patients undergoing PD therapy, comparing those who experienced peritonitis with those who did not. The research identified several key factors that significantly correlated with the occurrence of peritonitis:

The research categorized common pathogens that cause peritoneal dialysis (PD)-associated peritonitis. The most frequently identified pathogen was Gram-positive cocci (57.78%). The study showed that PD-associated peritonitis occurred 54 times in 41 patients.

  • Low Serum Albumin: Albumin is a protein in your blood, and low levels (below 29.1 g/L) can compromise your immune system and increase susceptibility to infection. The study found that low serum albumin was a significant risk factor (p<0.001).
  • Low Blood Phosphorus: Phosphorus is an essential mineral, but low levels (below 1.795 mmol/L) were also linked to increased peritonitis risk (p=0.001).
  • Gastrointestinal Issues: A history of gastrointestinal disorders, like diarrhea or constipation, significantly elevated the risk of peritonitis (p=0.043).
  • Calcitriol Use: Interestingly, the use of calcitriol, a form of vitamin D often prescribed to manage mineral and bone disorders in dialysis patients, was associated with a reduced risk of peritonitis (p=0.048).
It's important to note that while the study identified these correlations, it doesn't definitively prove cause and effect. However, the findings offer valuable insights into potential areas for intervention and risk management.

Taking Control: What Can You Do to Minimize Your Risk?

While some risk factors, such as pre-existing gastrointestinal issues, might be difficult to eliminate, others are modifiable. Here's what you can discuss with your healthcare team:

<ul> <li><b>Monitor Albumin and Phosphorus Levels:</b> Regular blood tests can track these levels. Work with your doctor and a registered dietitian to optimize your nutrition and address any deficiencies through diet or supplements.</li> <li><b>Manage Gastrointestinal Health:</b> If you experience frequent diarrhea or constipation, seek medical advice. Addressing these issues can improve your overall health and potentially reduce your peritonitis risk.</li> <li><b>Discuss Calcitriol with Your Doctor:</b> If you're not currently taking calcitriol, discuss the potential benefits and risks with your physician. The study suggests it may offer some protection against peritonitis.</li> </ul>

Remember, proactive communication with your healthcare team is key to successful PD therapy. By understanding your individual risk factors and working collaboratively, you can minimize complications and enjoy a better quality of life.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1177/2058739218772243, Alternate LINK

Title: Risk Factors For Peritoneal Dialysis–Associated Peritonitis

Subject: Immunology

Journal: European Journal of Inflammation

Publisher: SAGE Publications

Authors: Hongyue Wang, Xiangtuo Wang, Haichuan Dou, Chenhao Li, Mingji Cui, Chunmei Gu, Liming Yang

Published: 2018-01-01

Everything You Need To Know

1

What is peritonitis in the context of peritoneal dialysis, and why is it a serious concern?

Peritonitis in peritoneal dialysis (PD) is an inflammation of the peritoneum, the membrane lining the abdominal cavity. This is a significant complication for PD patients. It can result in poor dialysis outcomes, damage to the peritoneal membrane, and even failure of the PD treatment. Addressing peritonitis is crucial for maintaining the effectiveness of peritoneal dialysis and the patient's overall health.

2

What are the key risk factors for peritonitis identified in the study of peritoneal dialysis patients?

The study identified several key factors correlated with peritonitis: low serum albumin (below 29.1 g/L), low blood phosphorus (below 1.795 mmol/L), and a history of gastrointestinal issues. Interestingly, the use of calcitriol, a form of vitamin D, was associated with a reduced risk of peritonitis. Gram-positive cocci was the most common pathogen.

3

How does low serum albumin increase the risk of peritonitis in peritoneal dialysis?

Low serum albumin indicates compromised immune function, making patients more susceptible to infections like peritonitis. Maintaining adequate serum albumin levels, often through proper nutrition and managing underlying health conditions, is vital for minimizing infection risk in peritoneal dialysis.

4

Why does the study say that calcitriol use is associated with a reduced risk of peritonitis?

The study suggests calcitriol use is associated with reduced peritonitis risk. Calcitriol is often prescribed to manage mineral and bone disorders in dialysis patients. However, this study suggests potential protective benefits against peritonitis. More research is needed to fully understand the mechanisms and confirm calcitriol's role in peritonitis prevention during peritoneal dialysis.

5

The study mentions gastrointestinal issues as a risk factor. What specific gastrointestinal disorders increase peritonitis risk in peritoneal dialysis patients, and what are the underlying mechanisms?

While gastrointestinal issues like diarrhea or constipation were identified as risk factors, the study doesn't delve into the specific types of gastrointestinal disorders or their mechanisms for increasing peritonitis risk. Further investigation is needed to understand how specific gastrointestinal conditions impact peritoneal dialysis patients and how to manage these conditions to minimize peritonitis risk.

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