Which signs suggest a PD catheter obstruction?

• A. Poor or no drainage after a dwell, abdominal fullness, resistance during drainage.
• B. Normal drainage and no symptoms.
• C. Early fever.
• D. Weight loss.

Answer: (A)

When a PD catheter is obstructed, the outflow of dialysate is blocked, so drainage becomes impaired and backpressure builds in the abdomen. The most informative signs are poor or no drainage after a dwell, a feeling of abdominal fullness, and resistance when attempting to drain. Poor drainage happens because something is blocking the flow path, causing the fluid to stay in the abdomen and not exit as intended. Abdominal fullness follows from that retained dialysate, giving a noticeable distension or heaviness. Resistance during drainage is the patient or clinician feeling the flow becoming slow or halted as they try to drain.

Normal drainage with no symptoms isn’t due to obstruction, and fever suggests infection (such as peritonitis) rather than a mechanical blockage. Weight loss is a general, non-specific finding that doesn’t point to obstruction by itself.

If obstruction is suspected, check for common mechanical causes like kinks in tubing or a catheter tip positioned against a structure; reposition the patient, adjust the catheter, and avoid forcing the drain. If drainage remains poor despite these checks, contact the PD care team promptly, as persistent obstruction may require more definitive management such as repositioning or surgical intervention.