Noninfectious complications of peritoneal dialysis

The steady decrease in the incidence of bacterial peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD) has allowed us to focus on noninfectious complications of peritoneal dialysis. Many of the complications result from the increased intra-abdominal pressure caused by the instillation of litres of fluid into a cavity which usually holds much less. Other complications arise because of the long-term effect of peritoneal dialysate directly on the mesothelial cells with which it has almost continuous contact, and more indirectly from the long-term metabolic consequences of this solution on the body’s physiochemistry. This chapter will address these and other complications of peritoneal dialysis.