When a dialysate leak is suspected at the catheter site, what is the recommended management first step?

• A. Stop PD, drain fluid, and evaluate with imaging.
• B. Continue PD.
• C. Increase dwell time.
• D. Use weight-based dosing for medications.

Answer: (A)

When a dialysate leak is suspected at the catheter site, the first step is to stop PD, drain the fluid, and obtain imaging to locate the leak and assess catheter integrity. Stopping PD prevents further dialysate loss and reduces the risk of infection or worsening abdominal distension, while draining clears the accumulated fluid and makes assessment safer. Imaging helps identify exactly where the leak is coming from—whether it’s at the catheter tract, from malposition, or another source—so the appropriate corrective action can be planned. After stabilizing and evaluating, decisions about resuming PD, switching to hemodialysis, or repairing the catheter can be made.

Continuing PD, increasing dwell time, or using weight-based dosing for medications do not address the leak itself and could worsen the patient’s condition or unnecessarily complicate management.