Case Report: A rare complication easily misdiagnosed as bacterial peritonitis: a case of sterile peritoneal dialysis-chemical peritonitis induced by amino-acid-based dialysate and literature review.

Abstract

Peritoneal dialysis-chemical peritonitis induced by amino acid-based peritoneal dialysis solution is extremely rare. There are only a few reported case series of this condition. It can occur at any time during the use of amino acid dialysate, and most cases present with abdominal pain, cloudy effluent, and elevated peritoneal leukocyte counts, closely mimicking infectious peritonitis. This similarity poses a significant diagnostic challenge, as it is difficult to distinguish from bacterial peritonitis. Here, we report a case of peritoneal dialysis-chemical peritonitis associated with amino acid dialysate in a patient on peritoneal dialysis, aiming to raise awareness among clinicians of this rare entity that can be easily confused with infectious peritonitis. We also review its clinical characteristics, differential diagnosis, and management.