What is the recommended response to a patient with persistent leakage after PD catheter placement?

• A. Perform routine dialysis without changes.
• B. Proceed with exchanges and ignore potential leaks.
• C. Apply pressure dressings and wait for spontaneous resolution.
• D. Evaluate for leaks, halt exchanges if necessary, immobilize temporarily, and consider imaging or surgical intervention if persistent.

Answer: (D)

Persistent leakage after PD catheter placement signals that the tract hasn’t sealed and that continuing normal exchanges can worsen the leak, drain dialysate, and increase infection risk. The best approach is to actively evaluate for leaks, pause exchanges as needed to reduce pressure on the tract, and immobilize the catheter to encourage sealing. If the leak remains after this initial pause, use imaging to locate the source and consider surgical intervention or catheter repositioning to restore a safe and functional PD setup.

Routine dialysis without changes ignores the leak and can worsen outcomes. Trying to manage with only pressure dressings and waiting delays proper assessment and can prolong the problem.