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While electrolyte disturbances can occur, they are typically not as severe as in patients on hemodialysis. As the patient’s dialysis exchange occurs over a longer period, there is less gradient with the dialysate and electrolyte shifts are less abrupt.

The most common and serious complication in peritoneal dialysis is peritonitis, contributing to the cause of death for over 15% of peritoneal dialysis patients. The indwelling abdominal catheter is a nidus for infection. Patients with peritonitis may complain of abdominal pain or nonspecific symptoms of nausea, fatigue, or fever. They may range from being asymptomatic to frankly septic, with guarding of the abdomen and hypotension. Signs of peritonitis for the prehospital clinician include a change in the fluid coming from the catheter during a fluid exchange or purulent drainage from the catheter insertion site [31].

The fluid used for dialysis in peritoneal dialysis often contains high amounts of glucose, drawing water out of the body. In rare cases, patients can absorb the glucose and present with a hyperglycemic, hyperosmolar state and resulting critical illness from the same [32].