An infection in the peritoneum that is a major complication of peritoneal dialysis with a high risk of hospitalization, loss of catheter, and technique failure. Diagnosis requires the presence of two of the following: 1) organisms identified on gram staining or subsequent culture; 2) cloudy fluid (white cell count greater than 100/m3; greater than 50% neutrophils); and 3) signs and symptoms of peritoneal inflammation. Cloudy dialysate effluent is almost always present and abdominal pain is present in about 80-95% of the time. Patients can have gastrointestinal symptoms, chills, and fever in about 25% of the cases and abdominal tenderness in about 75%. Bacteremia is rare and gram staining of the effluent is not always helpful except in cases of fungal peritonitis. Up to 20% of the cases will have no bacterial growth in the culture which may be due to a technical error that occurred during collection and/or transportation.
Vardhan, A. & Hutchison, A.J. (2014). Peritoneal dialysis (pp. 520-533). In S.J. Gilbert, D.E. Weiner, D.S. Gipson, M.A. Perazella, & M. Tonelli. (Eds., 6th ed.), pp. 520-553. National Kidney Foundation, Primer on Kidney Diseases. 6th ed. Philadelphia: Elsevier Saunders. pp. 520-533.