Questions About PD
Generally, any patient with inflammation of the intestines is at increased risk of translocation of organisms across the bowel wall into the peritoneal cavity. Early treatment to control the inflammation is important. In this case the suspected inflamed appendicitis has been removed and appropriate antibiotics has been given. Chances of the patient to developed peritonitis is high once there is any inflammation in the abdomen in general. Therefore, it is not a surprise that the patient had developed peritonitis subsequently.
Treatment of the peritonitis is following the ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment. (Li et al. Perit Dial Int. 2016 Sep 10;36(5):481-508)
There are no data on whether holding PD temporarily would decrease the risk of enteric peritonitis, but if a patient has severe colitis and adequate residual renal function, holding PD for 24-48 hours could be considered. Removal of catheter is considered in refractory peritonitis or if the patient is at risk of septic shock, at the discretion of the managing nephrologists.