JAMA Diagnostic Test Interpretation
November 10, 2022
Peritoneal Fluid Analysis in Peritoneal Dialysis–Associated Peritonitis
Jeffrey Perl, Ziv Harel, Sharon J. Nessim
JAMA. Published online November 10, 2022. doi:10.1001/jama.2022.21289
A62-year-old woman undergoing peritoneal dialysis (PD) for kidney failure due to IgA nephropathy presented to the PD clinic with a 1-day history of severe abdominal pain and cloudy PD fluid. Seven days prior, she inadvertently broke aseptic technique when tightening a leaking connection of her PD catheter tubing. On presentation, she was afebrile and had normal vital signs. Physical examination revealed diffuse abdominal tenderness. Cloudy fluid that was drained from her PD catheter was sent for laboratory analysis (Table 1).
What Would You Do Next?
- Administer empirical broad-spectrum intraperitoneal antibiotics
- Administer empirical broad-spectrum intravenous antibiotics
- Await peritoneal dialysis fluid culture results before starting intraperitoneal antibiotics
- Send blood cultures
