Peritoneal Dialysis Catheter Care: Preventing Infection
Posted 16 Jul 2026 | Source:
For anyone on peritoneal dialysis, looking after the catheter and the place where it exits the skin — the exit site — is one of the most important responsibilities, because good care is the main way to prevent infection. Infection is the principal complication of peritoneal dialysis, and the great majority of it can be avoided through careful, consistent technique. This article explains the essentials of catheter and exit site care.
Why catheter care matters so much
The peritoneal dialysis catheter provides a route from the outside world into the abdominal cavity. This is what makes the treatment possible, but it also means that, without proper care, germs could travel along this route and cause infection — either at the exit site, in the tunnel where the catheter passes under the skin, or, most seriously, inside the abdominal cavity, where it causes peritonitis.
Because these infections can be serious and disruptive, and because they are largely preventable, careful catheter care is fundamental to safe and successful peritoneal dialysis. The good news is that the techniques involved, while requiring consistency, are entirely learnable and become routine.
Caring for the exit site
The exit site — where the catheter emerges from the skin — needs regular, careful attention. The principles are to keep it clean and dry and to handle it gently and hygienically. You will be taught a specific routine for cleaning the exit site, typically performed regularly, using the methods and materials your unit recommends, and for applying any dressing as advised. Thorough hand hygiene before touching the catheter or exit site is essential every single time, as clean hands are one of the most powerful defences against infection. The catheter should also be secured so that it does not get tugged or pulled, since movement and trauma at the exit site can damage it and create an opening for infection.
Keeping the exit site dry is important, which means taking care with bathing according to the guidance you are given, and ensuring the area is properly dried if it does get wet. You will also be taught to inspect the exit site regularly for any early signs of a problem, so that anything amiss is caught quickly.
Hygiene during exchanges
Beyond exit site care, the technique used during the exchanges themselves is crucial for preventing peritonitis. The connections involved in introducing and draining fluid must be made with scrupulous hygiene, following exactly the steps you are taught, so that germs are not introduced into the system and thence into the abdomen. This includes thorough hand washing, performing exchanges in a clean environment free from draughts and disturbance, wearing a mask if advised, and never touching the parts that must remain sterile. These steps, performed consistently every time, are what keep the system safe. Your training will cover them in detail, and following them faithfully is the single most effective thing you can do to avoid peritonitis.
Recognising the signs of infection
Knowing the signs of infection and acting on them promptly is vital, because early treatment is much more effective. At the exit site or in the tunnel, signs of infection include redness, swelling, tenderness or pain, warmth, or any discharge of pus or fluid around the catheter. Peritonitis — infection within the abdominal cavity — typically causes cloudy dialysis fluid when it is drained out, which is often the earliest and most important sign, along with abdominal pain or tenderness, and sometimes fever, nausea, or feeling generally unwell. Cloudy drained fluid in particular should always prompt immediate contact with your kidney team, as it is the hallmark of peritonitis and needs prompt treatment.
What to do if you suspect infection
If you notice any signs of infection — whether redness or discharge at the exit site, or cloudy fluid, abdominal pain, or feeling unwell suggesting peritonitis — the right action is to contact your peritoneal dialysis team promptly rather than waiting to see if it settles. Peritonitis and catheter infections are treatable, often very effectively, when addressed early, but delay allows them to become more serious and harder to treat, and can in some cases threaten the ability to continue peritoneal dialysis. Your team would much rather hear from you early about a concern that turns out to be minor than be contacted late about an established infection. Keeping their contact details readily available, and not hesitating to use them, is part of safe peritoneal dialysis.
The reassuring reality
While this article necessarily emphasises infection and its prevention, the reassuring reality is that very many people perform peritoneal dialysis for years with few or no infections, precisely because they follow good technique. The routines of exit site care and hygienic exchanges, daunting as they may sound at first, become second nature with training and practice. Your peritoneal dialysis team provides thorough training and ongoing support, and is always available to help. With consistent care, the catheter becomes a reliable and well-tolerated part of a treatment that allows independent, home-based management of kidney failure.
The takeaway
Caring for your peritoneal dialysis catheter and exit site — keeping the exit site clean and dry, performing exchanges with scrupulous hygiene, securing the catheter, and watching for signs of infection — is the foundation of safe peritoneal dialysis.
Cloudy drained fluid or signs of infection at the exit site should prompt prompt contact with your team. With consistent good technique, infections are largely preventable, and peritoneal dialysis can be carried out safely and successfully at home for years.
Good catheter care is the key to safe peritoneal dialysis. Your nephrologist and peritoneal dialysis team provide training and support, and are always available for concerns. A video consultation is a convenient way to discuss any questions.
