Questions About PD
While we cannot comment on management of specific cases, the 2016 ISPD peritonitis guideline outlines the timing of PD catheter re-insertion after peritonitis below:
“We suggest that if re-insertion of a new catheter is attempted after a PD catheter is removed for refractory, relapsing, or fungal peritonitis, it be performed at least 2 weeks after catheter removal and complete resolution of peritoneal symptoms (2D).”
“Observational studies suggest that effective antibiotics should be continued for at least 2 weeks after catheter removal for refractory peritonitis…There are few data on the optimal duration between catheter removal for peritonitis and re-insertion of a new catheter. Observational studies suggest a minimum period of 2 to 3 weeks, although some would recommend later re-insertion in cases of fungal peritonitis. Re-insertion of a new catheter should be done by laparoscopic or mini-laparotomy approach so that adhesion can be directly visualized. Ultrafiltration problems are common after return to PD”.