How do you manage a patient on peritoneal dialysis who develops a single episode of cloudy effluent with a low cell count and no organisms on Gram stain while remaining clinically well?

There is a relatively broad differential diagnosis for patients presenting with cloudy dialysis fluid that appears to be non-infectious in nature (Rocklin & Teitelbaum, PMID 11208038). While the differential for fluid that is totally acellular is relatively narrow - fibrin or triglycerides are the u...

Over treatment with antibiotics are not helpful!

I would treat with ABX until culture results are back.

Also, check for lipids in PD fluids in this situation.

Evolving technology that’s already in use in daily practice in some centers helps with earlier diagnostics (before symptoms start). I invite you to read the CATCH study published in KI in 2024 and a follow-up abstract presented at the ASN last year. Williamson et al., Journal of the American Society...