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Infusion pain is a frequent problem in PD with marked variation in intensity and risk. Among the many etiologies are peritonitis and other inflammatory processes of the peritoneum, accidental infusion of air, acidic pH of conventional dialysate, expired dialysate with high concentrations of GDPs, extreme temperatures of dialysis solution, hypertonicity of the solution, rapid infusion rates and high pCO2 levels in the PDF. Infusion pain also results from stretching of the intraperitoneal structures as in the case of compartmentalization due to adhesions.
Diagnosis and Management. The diagnosis relies on a history and physical findings consistent with the above etiologies. Adhesions and compartmentalization are best confirmed through air contrast cannulography or CT scan of the abdomen. The treatment is dictated by the specific cause.
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