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SCLEROSING PERITONITIS-THE CONTRIBUTION OF CHLORHEXIDINE IN ALCOHOL

From the ^* Renal Unit, Western Infirmary and^** Renal Unit, Royal Infirmary, Glasgow, Scotland.

Sclerosing peritonitis now is recognized as an extremely serious complication of peritoneal dialysis. In Glasgow II of 162 patients on CAPD developed sclerosing peritonitis. All 11 came from a group of 54 patients, who used a connecting system that allowed small quantities of the antiseptic spray, chlorhexidine in alcohol, to enter the abdomen. Experiments showed that I ml of this solution added to 2 litres of dialysate produced up to a 20.fold increase in the particle count of the dialysate. Scanning electron microscopy suggested that these particles probably were plastic. In rats intraperitoneal injections of a mixture of antiseptic spray and dialysate produced an inflammatory reaction in the submesothelial tissues, which might represent the early changes of a fibrotic process. To prevent possible longterm complications such as sclerosing peritonitis we should avoid the introduction into the peritoneal cavity of any unnecessary substance and in particular chlorhexidine in alcohol.

KEY WORDS: Sclerosing peritonitis; CAPD; chlorhexidine in alcohol.

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