Infection Behind the Scenes: The Hidden Realities of Peritonitis in Chronic Kidney Disease Patients on CAPD

Abstract

Peritonitis remains a major complication and a leading cause of hospitalization among patients undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD), significantly impacting both their quality of life and survival rates. This article aims to synthesize existing knowledge and analyze the risk factors associated with peritonitis in chronic kidney disease patients receiving CAPD. By integrating international standard guidelines (ISPD 2022) with the physiological and environmental contexts of Thailand, the article highlights the crucial role of nurses in supporting the self-care management of patients and their caregivers. However, an analysis of patient experiences reveals a critical "gap between knowledge and actual practice" that leads to infection incidents. These risks can be categorized into three dimensions: 1) the behavioral dimension, stemming from habituation, standard deviation, and the misinterpretation of hygiene; 2) the environmental dimension, arising from residential space limitations and improper equipment storage; and 3) the socio-psychological dimension, resulting from prolonged treatment fatigue, which leads to hidden depression and laxity in preventive measures. These insights underscore the necessity for continuous assessment, monitoring, and the design of tailored care plans that align with the realistic living contexts of individual patients, ultimately aiming to sustainably reduce infection rates and enhance their overall quality of life.