Questions About PD
Swimming is not contraindicated in PD, however the exit site care must be given extra attention after the activities. The exit site must be dry post swimming to prevent possibility of ESI. Colostomy bag can be use to contain the PD catheter. However, if swimming cause exit site infection recurrently for this patient, it is advisable not to pursue it anymore. The care must be a shared decision and the parents must always be aware of the possible risks.
We thank you for your question. We agree with the response above and would like to add that there is, indeed, limited information on this topic. A recent survey of nurses from 39 home PD units in Australia published in Peritoneal Dialysis International found that, in general:
“Almost all units reported that patients on PD do swim despite only 77% of units advocating swimming. Swimming in sea water (85%) or a private swimming pool (90%) is mostly recommended. Covering the exit site and PD catheter is recommended with a waterproof film dressing or colostomy bag. Performing routine exit-site care after swimming is recommended (100%). There were 7 reported exit-site infections and 2 episodes of peritonitis perceived to be associated with swimming with a PD catheter” (1).
The authors of much earlier published guidelines for pediatric patients on PD make the following recommendation:
“Swimming is not encouraged, especially in public pools, lakes or rivers, and whirlpools or hot tubs. It can take place with good supervision and with occlusive dressings covering the exit site and catheter after the 6-week healing period. An immediate dressing change should take place after swimming” (2).
- Lee A. Swimming on peritoneal dialysis: recommendations from Australian PD units. Peritoneal Dialysis International. 2019 Nov;39(6):527-31.
2. Watson AR, Gartland C, European Paediatric Peritoneal Dialysis Working Group. Guidelines by an ad hoc European committee for elective chronic peritoneal dialysis in pediatric patients. Peritoneal dialysis international. 2001 May;21(3):240-4.