Exit-Site Care Adherence in Peritoneal Dialysis: Real-World Practice and Outcomes

Authors

  • Jadon Ryan Yang 1. Concord Repatriation General Hospital, Concord, NSW, Australia | 2. Blacktown Clinical School, School of Medicine, Western Sydney University, Blacktown, NSW, Australia Author https://orcid.org/0009-0004-8226-8226
  • Jason Ton 2. Blacktown Clinical School, School of Medicine, Western Sydney University, Blacktown, NSW, Australia Author
  • Maria Daraoay 3. Department of Renal Medicine, Blacktown Hospital, Western Sydney Local Health District, Sydney, NSW, Australia Author
  • Lukas Kairaitis 2. Blacktown Clinical School, School of Medicine, Western Sydney University, Blacktown, NSW, Australia | 3. Department of Renal Medicine, Blacktown Hospital, Western Sydney Local Health District, Sydney, NSW, Australia Author
  • John Wing Li 2. Blacktown Clinical School, School of Medicine, Western Sydney University, Blacktown, NSW, Australia | 3. Department of Renal Medicine, Blacktown Hospital, Western Sydney Local Health District, Sydney, NSW, Australia | 4. School of Medicine, The University of Notre Dame Australia, Darlinghurst, NSW, Australia Author
  • Kamal Sud 5. Nepean Kidney Research Centre, Department of Renal Medicine, Nepean Hospital, Kingswood, NSW, Australia | 6. Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Kingswood, NSW, Australia Author
  • Katrina Chau 2. Blacktown Clinical School, School of Medicine, Western Sydney University, Blacktown, NSW, Australia | 3. Department of Renal Medicine, Blacktown Hospital, Western Sydney Local Health District, Sydney, NSW, Australia Author

DOI:

https://doi.org/10.64945/6afcbw08

Keywords:

Peritoneal Dialysis, Catheter-Related Infections, Exit-Site Infections, Peritonitis, Adherence

Abstract

Introduction
Peritoneal dialysis catheter-related infections represent a major source of morbidity, yet the optimal components of exit-site care and the role of patient adherence remain uncertain. This study evaluated real-world exit-site care practices, adherence, and associations with infection outcomes in a multicultural Australian peritoneal dialysis cohort. 


Methods
A cross-sectional observational study was conducted within a metropolitan renal service. Adult patients attending routine follow-up completed a structured interviewer-administered survey capturing recalled training instructions, current practices, and reasons for non-adherence. Infection outcomes were obtained from registry and electronic medical record data, and adherence was assessed against both recalled instructions and local protocol. 


Results
A total of 103 participants were included. Non-adherence to recalled training instructions was observed in 50% of participants, while 47% did not meet local protocol requirements. Exit-site care practices varied substantially, particularly regarding antiseptic choice and cleansing frequency. Peritonitis and catheter-related infection rates were low (0.26 and 0.11 episodes per patient-year, respectively) and within guideline targets. No significant associations were identified between adherence measures or specific care practices and infection outcomes. Adverse reactions, most commonly related to antibacterial honey, were the leading reason for deviation from recalled instructions. 


Conclusion
Substantial heterogeneity in exit-site care practices was observed without evidence of worse infection outcomes. Within this local context, strict adherence to intensive exit-site care regimens may not be necessary to maintain acceptable infection rates when minimum hygiene standards are preserved. Simplified approaches prioritising tolerability may improve sustainability and patient acceptability without compromising safety.

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Published

31.08.2026

Issue

Vol. 1 No. 2 (2026)

Section

Original Research Articles

License

Copyright (c) 2026 Jadon Ryan Yang, Jason Ton, Maria Daraoay, Lukas Kairaitis, John Wing Li, Kamal Sud, Katrina Chau (Author)

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This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0), which permits non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited, and any derived works are licensed under the same terms.

The copyright remains with the author(s). The authors grant Australasian Journal of Clinical Nephrology the non-exclusive right to publish and distribute the article.

To view a copy of this license, visit: https://creativecommons.org/licenses/by-nc-sa/4.0/

 

How to Cite

Exit-Site Care Adherence in Peritoneal Dialysis: Real-World Practice and Outcomes. (2026). Australasian Journal of Clinical Nephrology, 1(2). https://doi.org/10.64945/6afcbw08