UK National Kidney Federation - Peritoneal Dialysis

The possible complications that can occur after a PD catheter insertion include:

Infection:	The operation site, the site where the catheter exits the tummy, or the peritoneum can sometimes become infected after the PD insertion. Antibiotics given before the operation usually prevent this from happening. If the peritoneum is infected, the person may develop a high temperature, and get bad tummy pain. A sample of PD fluid is taken and analysed to confirm if there is an infection, and what organism has caused it. An infection of the peritoneum is called peritonitis, and it is treated with antibiotics.
Bowel or bladder complications:	Accidental damage to the bowel or bladder caused by the PD insertion is rare. Faeces from the bowel will flow down the catheter if the bowel has been damaged (known as perforation of the bowel), and the person might have tummy pain. If the bowel has been perforated, an operation is needed to repair it. People are asked not eat after the insertion until a doctor has checked that their bowel sounds are normal. If the bladder is damaged, the person will pass large volumes of very dilute urine and get spasm-type low tummy pain. An operation would be needed to repair the bladder if it was damaged.
Bleeding post insertion:	The peritoneum has lots of small blood vessels, so it is normal to find some blood or clots in the PD fluid drained out after the insertion. It is also quite normal for some oozing of blood to occur at the operation site, and at the exit site. If any of the larger blood vessels in the tummy region are damaged during the operation, a lot of blood could drain out with the PD fluid, accompanied by a fall in blood pressure, and a raised pulse rate. The person would need to return to theatre for the damage to be assessed and repaired.
Leaks:	Sometimes after the insertion fluid can leak out of the exit site, or leak down into the scrotum (in males) or vagina (in females). If this happens the catheter is not used for 2-4 weeks and the area that has leaked will usually repair itself. Swelling usually goes down after a few days, if no more fluid is drained into the peritoneum.
Drainage problems:	A problem which can occur after insertion is difficulty draining fluid in and out of the catheter. This can be a result of a blood clot blocking the catheter, or that the catheter was not positioned correctly or it has moved in the peritoneum. An x-ray will show where the catheter is lying. An operation may be needed to reposition the catheter. About 1 in 10 to 1 in 20 people need to have their catheter repositioned. A leak or drainage problems can happen immediately post insertion, or after a few weeks, or even years!

Infection:

The operation site, the site where the catheter exits the tummy, or the peritoneum can sometimes become infected after the PD insertion. Antibiotics given before the operation usually prevent this from happening. If the peritoneum is infected, the person may develop a high temperature, and get bad tummy pain. A sample of PD fluid is taken and analysed to confirm if there is an infection, and what organism has caused it. An infection of the peritoneum is called peritonitis, and it is treated with antibiotics.

Bowel or bladder complications:

Accidental damage to the bowel or bladder caused by the PD insertion is rare. Faeces from the bowel will flow down the catheter if the bowel has been damaged (known as perforation of the bowel), and the person might have tummy pain. If the bowel has been perforated, an operation is needed to repair it. People are asked not eat after the insertion until a doctor has checked that their bowel sounds are normal. If the bladder is damaged, the person will pass large volumes of very dilute urine and get spasm-type low tummy pain. An operation would be needed to repair the bladder if it was damaged.

Bleeding post insertion:

The peritoneum has lots of small blood vessels, so it is normal to find some blood or clots in the PD fluid drained out after the insertion. It is also quite normal for some oozing of blood to occur at the operation site, and at the exit site. If any of the larger blood vessels in the tummy region are damaged during the operation, a lot of blood could drain out with the PD fluid, accompanied by a fall in blood pressure, and a raised pulse rate. The person would need to return to theatre for the damage to be assessed and repaired.

Leaks:

Sometimes after the insertion fluid can leak out of the exit site, or leak down into the scrotum (in males) or vagina (in females). If this happens the catheter is not used for 2-4 weeks and the area that has leaked will usually repair itself. Swelling usually goes down after a few days, if no more fluid is drained into the peritoneum.

Drainage problems:

A problem which can occur after insertion is difficulty draining fluid in and out of the catheter. This can be a result of a blood clot blocking the catheter, or that the catheter was not positioned correctly or it has moved in the peritoneum. An x-ray will show where the catheter is lying. An operation may be needed to reposition the catheter. About 1 in 10 to 1 in 20 people need to have their catheter repositioned. A leak or drainage problems can happen immediately post insertion, or after a few weeks, or even years!

NKF Controlled Document No. 241, What are the possible complications of a PD insertion?, written 26 January 2001. Last reviewed 28 January 2010.

The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.

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Page created: 26 January 2001

Last updated: 27 February 2011