Peritonitis following subcutaneous embedding of peritoneal dialysis catheters at PD discontinuation: two cases within a six-patient institutional series and a literature review
- 1Department of Nephrology, Matsuyama Red Cross Hospital
- 2Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
Abstract
Background Subcutaneous embedding of a peritoneal dialysis (PD) catheter at the time of PD discontinuation has been proposed as a strategy to avoid invasive catheter removal while preserving the option of resuming PD in the future. However, the risk of peritonitis after catheter embedding remains poorly understood. We describe all six patients treated at our institution, focusing on the two who developed peritonitis. Case presentation Since 2020, six patients (four men; age range, 32–88 years) underwent secondary catheter embedding at PD discontinuation. PD duration ranged from 3 to 96 months, and five patients had prior PD-related peritonitis. At embedding, three had hypoalbuminemia and three had mildly elevated serum C-reactive protein levels. Embedding was selected to preserve a possible future PD option or reduce procedural burden because of frailty, comorbidity, or refusal of further surgery. During 14–63 months of follow-up, two patients developed three episodes of presumed endogenous peritonitis, whereas four had no documented peritonitis; no catheter was re-exteriorized. Both affected patients had discontinued PD because of ultrafiltration failure after long-term PD and had persistent ascites. Case 1 developed culture-negative, neutrophil-predominant peritonitis after antimicrobial exposure. Case 2 developed Campylobacter enteritis-associated peritonitis and later culture-positive peritonitis with Streptococcus mitis despite a low ascitic cell count. Antibiotics improved the acute inflammatory findings in both patients; persistent ascites and gastrointestinal symptoms prompted corticosteroid treatment for suspected evolving encapsulating peritoneal sclerosis (EPS). Conclusions This small, heterogeneous series cannot estimate peritonitis incidence or establish risk factors. Nevertheless, the occurrence of presumed endogenous peritonitis in two patients with persistent ascites after PD discontinuation suggests that careful patient selection and monitoring may be warranted.
Related
- Peritoneal dialysis-associated peritonitis caused by Ureaplasma urealyticum : A case report
- Peritoneal Dialysis-Associated Peritonitis due to Pasteurella multocida: A Rare Case of Stray-Animal Exposure and Fluoroquinolone Resistance
- Clinical characteristics and preliminary discriminatory value of low triiodothyronine syndrome in patients with peritoneal dialysis-associated peritonitis : A cross-sectional study
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- Diagnosis and minimally invasive surgical treatment of peritoneal dialysis-associated pleuroperitoneal fistula: A case report and literature review.
BibTeX
@article{oga2026peritonitis,
title = {{Peritonitis following subcutaneous embedding of peritoneal dialysis catheters at PD discontinuation: two cases within a six-patient institutional series and a literature review}},
author = {Kenji Oga and Hideaki Oka and Keiko Ochi and Azusa Morihara and Hiroyasu Magota and Kana Ota and Toshiaki Hatanaka and Keishiro Fujimoto and Haruka Sumi and Mika Kibune and Taro Kamimura and Tetsuro Ago and Shunsuke Yamada},
journal = {Renal Replacement Therapy},
year = {2026},
month = oct,
doi = {10.1186/s41100-026-00782-4},
url = {https://doi.org/10.1186/s41100-026-00782-4},
note = {CC BY},
}
RIS
TY - JOUR
TI - Peritonitis following subcutaneous embedding of peritoneal dialysis catheters at PD discontinuation: two cases within a six-patient institutional series and a literature review
AU - Kenji Oga
AU - Hideaki Oka
AU - Keiko Ochi
AU - Azusa Morihara
AU - Hiroyasu Magota
AU - Kana Ota
AU - Toshiaki Hatanaka
AU - Keishiro Fujimoto
AU - Haruka Sumi
AU - Mika Kibune
AU - Taro Kamimura
AU - Tetsuro Ago
AU - Shunsuke Yamada
PY - 2026
DA - 2026/10/25
JO - Renal Replacement Therapy
DO - 10.1186/s41100-026-00782-4
UR - https://doi.org/10.1186/s41100-026-00782-4
AB - Background Subcutaneous embedding of a peritoneal dialysis (PD) catheter at the time of PD discontinuation has been proposed as a strategy to avoid invasive catheter removal while preserving the option of resuming PD in the future. However, the risk of peritonitis after catheter embedding remains poorly understood. We describe all six patients treated at our institution, focusing on the two who developed peritonitis. Case presentation Since 2020, six patients (four men; age range, 32–88 years) underwent secondary catheter embedding at PD discontinuation. PD duration ranged from 3 to 96 months, and five patients had prior PD-related peritonitis. At embedding, three had hypoalbuminemia and three had mildly elevated serum C-reactive protein levels. Embedding was selected to preserve a possible future PD option or reduce procedural burden because of frailty, comorbidity, or refusal of further surgery. During 14–63 months of follow-up, two patients developed three episodes of presumed endogenous peritonitis, whereas four had no documented peritonitis; no catheter was re-exteriorized. Both affected patients had discontinued PD because of ultrafiltration failure after long-term PD and had persistent ascites. Case 1 developed culture-negative, neutrophil-predominant peritonitis after antimicrobial exposure. Case 2 developed Campylobacter enteritis-associated peritonitis and later culture-positive peritonitis with Streptococcus mitis despite a low ascitic cell count. Antibiotics improved the acute inflammatory findings in both patients; persistent ascites and gastrointestinal symptoms prompted corticosteroid treatment for suspected evolving encapsulating peritoneal sclerosis (EPS). Conclusions This small, heterogeneous series cannot estimate peritonitis incidence or establish risk factors. Nevertheless, the occurrence of presumed endogenous peritonitis in two patients with persistent ascites after PD discontinuation suggests that careful patient selection and monitoring may be warranted.
SN - 2059-1381
ER -