Continuous ambulatory peritoneal dialysis—a guide to imaging appearances and complications

OBJECTIVES: The aim of this article is to review and illustrate the typical imaging findings for a patient on continuous ambulatory peritoneal dialysis (CAPD) and its complications, examining the uses and limitations of multimodality imaging. BACKGROUND: CAPD is a commonly and increasingly used method of renal replacement therapy in end-stage renal failure (ESRF). From the set-up and insertion of the peritoneal catheter through to the actual treatment, there are pitfalls and complications that may adversely affect the patient and compromise the success of the dialysis. Complications can be either immediate or delayed, and can also be categorised into infectious and non-infectious aetiologies, including catheter failure, dialysate leaks, hernias and encapsulating sclerosing peritonitis. CONCLUSION: Early recognition of complications, both clinically and on the different imaging modalities, is essential in the management of CAPD in order to reduce treatment failure and limit patient morbidity and mortality. MAIN MESSAGES: Complications of peritoneal dialysis cause patient morbidity and treatment failure. Early recognition of complications from normal appearances is essential to limit dialysis failure. Multimodality imaging plays an important role in the diagnosis of these complications.