Differential Diagnosis of Non-infectious Cloudy Effluent
1Increased neutrophils
- Intra-abdominal pathology
-
- Cholecystitis1
- Appendicitis1
- Bowel ischemia1
- Pancreatitis1
- Organ infarction1
- Drug associated1
-
- Amphotericin B1
- Vancomycin1
- Contamination of PD fluid
-
- Endotoxin1
- Specimen from “dry” abdomen
2Increased eosinophils2
- Allergic reaction to sterilant or plasticizer
-
- Tubing/transfer sets
- Dialysis solution bags
- Peritoneal catheter
- Intraperitoneal air
- Drug associated
-
- Vancomycin
- Gentamicin
- Cephalosporins
3Increased erythrocytes
- Any cause of hemoperitoneum
- Retrograde menstruation2
- Ovulation2
- Ovarian/hepatic cyst rupture2
- Peritoneal adhesions2
- Strenuous exercise2
- Catheter-associated trauma2
4Increased malignant cells
- Lymphoma2
- Peritoneal metastases2
Noncellular causes
5Increased fibrin
- Post peritonitis
- Starting PD
6Increased triglycerides1, 2
- Acute pancreatitis
- Neoplasms/lymphoma
- Superior vena cava syndrome
- Drug associated
-
- Calcium channel blockers
- Chylous ascites
References used in this Appendix section
- Teitelbaum I. Cloudy peritoneal dialysate: it’s not always infection. Contrib Nephrol 2006;150:187–94.
- Rocklin MA, Teitelbaum I. Noninfectious causes of cloudy peritoneal dialysate. Semin Dial 2001; 14:37–40.
