Patient Resources 9 min read·Updated 22 July 2026 Clinician-reviewed

PD Catheter Care

A UK Consultant Nephrologist on keeping your peritoneal dialysis (PD) catheter and exit site healthy — preventing peritonitis, daily cleaning and what to do if something looks wrong.

  • Clinically Reviewed
  • NHS & NICE Aligned
  • UK Evidence-Based
  • Last Reviewed 22 July 2026

Professor Mohammed Mahdi Althaf

Consultant Nephrologist & Acute Physician

View Credentials

Professor Mohammed Mahdi Althaf

MD, MSc, PgDip (Clin Ed), FRCP, FHEA, FASN

Consultant Nephrologist & Acute Physician · GMC 7216325

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Direct answer

Your PD catheter is a permanent route into your peritoneum. Daily exit-site care, careful hand hygiene at exchanges, and IMMEDIATE attention to cloudy fluid are the three things that keep peritonitis rates low and PD working for years.

Key recommendation: Clean exit site daily after showering.

Quick answer

✓ Best choices

  • Higher-quality protein at every meal: eggs, fish, chicken, lean meat
  • Lower-phosphate, lower-potassium snacks between meals
  • Phosphate binders taken with food exactly as prescribed
  • A vitamin approach in line with renal nutrition principles (water-soluble B and C are commonly recommended; high-dose vitamin A is avoided)

✓ Foods to limit

  • High-phosphate foods: hard cheese, processed meats, cola, phosphate additives
  • Very high-potassium foods: bananas, oranges, tomatoes, potatoes (unless leached), avocado, chocolate
  • Fluid above your daily allowance — including soup, ice and high-water fruit

Key takeaway

Your PD catheter is a permanent route into your peritoneum. Daily exit-site care, careful hand hygiene at exchanges, and IMMEDIATE attention to cloudy fluid are the three things that keep peritonitis rates low and PD working for years.

Who should be cautious

People on dialysis, post-transplant, pregnant or breastfeeding, or taking prescription medication — confirm with your renal team before changes.

PD Catheter Care

The exit site — daily routine

  1. Wash hands thoroughly for 30 seconds.
  2. Shower (do not soak in bath).
  3. Pat the exit site dry with clean towel — don't rub.
  4. Clean the skin around the exit site with sterile saline or chlorhexidine wipes (per local protocol).
  5. Apply mupirocin or gentamicin ointment if your unit prescribes (proven to reduce exit-site infections).
  6. Cover lightly if discharge present; otherwise leave exposed to air.
  7. Tape the catheter securely with a 'stress loop' so any tug doesn't pull on the exit site.

What a healthy exit site looks like

  • Skin: pink, dry, no swelling
  • No discharge or scabbing
  • No pain
  • Catheter cuff invisible under skin

Signs of trouble — call the unit:

  • Redness extending more than 2mm around the site
  • Pus or yellow/green discharge
  • Swelling, warmth or pain
  • Catheter cuff visible (extrusion)

Preventing peritonitis

Peritonitis affects ~1 episode per 24 patient-months in UK PD. Key prevention:

  1. HAND HYGIENE: wash with soap for 30 seconds OR alcohol gel before every exchange.
  2. EXCHANGE TECHNIQUE: never touch the open ends of the tubing or bag connector.
  3. EXIT SITE: daily care as above.
  4. PETS: keep cats and dogs out of the exchange room.
  5. ENVIRONMENT: clean, dust-free, no draughts; close windows during exchanges.
  6. SUPPLIES: check bags are not damaged, leaking or cloudy BEFORE connecting.

If you are on dialysis, follow the supplement plan your renal team has prescribed. Kidney Vitality is a non-prescription daily multivitamin developed using renal nutrition principles — always confirm any new supplement with your team first. See the formulation.

Spotting peritonitis early

The earliest sign is almost always CLOUDY DRAINED FLUID. Other signs:

  • Abdominal pain (cramping, often diffuse)
  • Tenderness when you press your belly
  • Fever > 38°C
  • Nausea, vomiting, diarrhoea
  • Loss of appetite

What To Do

  • Keep the cloudy bag — don't throw it away
  • Call the PD unit immediately (24/7 emergency line)
  • Bring the cloudy bag to the unit for culture
  • Antibiotics added to the dialysis fluid usually within 2 hours

Delay > 24 hours significantly worsens outcomes.

Swimming, showers and baths

  • Daily showers: YES, once exit site is fully healed.
  • Baths: NO — submerging the exit site risks infection.
  • Public swimming pools and hot tubs: NO — high bacterial load.
  • Lakes and rivers: NO.
  • Clean sea swimming: only with a waterproof colostomy-style cover and PD unit approval.
  • Always thoroughly dry and re-clean the exit site immediately after any water exposure.

Lifestyle and clothes

  • Loose clothing around the waistband — tight belts pull on the catheter.
  • Catheter belt or fastener (Stomastix, PD belt) keeps it secure.
  • Avoid heavy lifting (> 10kg) — risks hernia where the catheter passes through abdominal wall.
  • Sex is fine — drain the abdomen first for comfort and tuck the catheter into a pouch or sock.
  • Avoid sit-ups, ab crunches — increases hernia risk.
Preparing for Dialysis
Related reading: Preparing for Dialysis.

Key practical tips

Designed for quick scanning — what to order, what to avoid, sensible portions, common mistakes.

  • Weigh between sessions to track fluid balance
  • Use the leaching (double-boil) method for potatoes and root veg
  • Plan a kidney-friendly snack to take to your session — protein helps

Clinical guidance

TL;DR summary

Your PD catheter is a permanent route into your peritoneum. Daily exit-site care, careful hand hygiene at exchanges, and IMMEDIATE attention to cloudy fluid are the three things that keep peritonitis rates low and PD working for years.

Key takeaways
  • Clean exit site daily after showering.
  • Mupirocin or gentamicin ointment if prescribed.
  • Wash hands thoroughly before every exchange.
  • Cloudy bag = peritonitis until proven otherwise.
  • No baths, swimming pools or hot tubs.
Kidney Diet & Nutrition Considerations on Dialysis

Dialysis nutrition is different from earlier-stage CKD. Protein needs go up (around 1.0–1.2 g/kg/day on haemodialysis) because dialysis removes amino acids. Potassium, phosphate and fluid restrictions tighten, and water-soluble B-vitamins are partly lost in the dialysate. Your renal dietitian sets your personal targets — these are the typical themes.

Foods to prioritise

  • Higher-quality protein at every meal: eggs, fish, chicken, lean meat
  • Lower-phosphate, lower-potassium snacks between meals
  • Phosphate binders taken with food exactly as prescribed
  • A vitamin approach in line with renal nutrition principles (water-soluble B and C are commonly recommended; high-dose vitamin A is avoided)

Foods to limit

  • High-phosphate foods: hard cheese, processed meats, cola, phosphate additives
  • Very high-potassium foods: bananas, oranges, tomatoes, potatoes (unless leached), avocado, chocolate
  • Fluid above your daily allowance — including soup, ice and high-water fruit

Potassium, phosphate and protein needs vary between individuals — please confirm personal targets with your renal team or dietitian. Browse the Kidney Diet Hub for more guides in this cluster.

Frequently asked questions

How do I clean my PD catheter exit site?

Daily after showering: pat dry, clean with sterile saline or chlorhexidine wipes (as advised by your PD nurse), apply mupirocin or gentamicin ointment to the exit site if prescribed, secure the catheter with tape so it doesn't pull. Never use creams, talc or perfumed products.

Can I shower with a PD catheter?

Yes — daily showers are encouraged once the exit site is fully healed (4–6 weeks post-insertion). Avoid baths, swimming pools, hot tubs and lakes/rivers. Sea swimming may be allowed with a waterproof dressing — check with your PD unit.

What is peritonitis and how do I spot it?

Peritonitis is infection inside the peritoneal cavity — the most serious PD complication. Signs: cloudy drained fluid (almost always the first sign), abdominal pain, fever, nausea. Call the PD unit immediately — start antibiotics within hours, not days.

Can I travel with PD?

Yes — PD is the most travel-friendly dialysis. Fluid bags can be delivered to your destination (UK and many countries). Plan 6–8 weeks ahead. Carry a doctor's letter, your last clinic letter, and extra catheter caps. Travel insurance must cover dialysis.

How much protein should I eat on dialysis?

Most adults on haemodialysis or peritoneal dialysis need around 1.0–1.2 g of protein per kilogram of body weight per day — higher than earlier CKD, because dialysis removes amino acids. Your renal dietitian sets your exact target based on your weight, albumin and bloods.

Nutritional challenges in kidney disease

Many people living with kidney disease have to limit foods because of potassium, phosphate, diabetes, dialysis, appetite changes or simply the time it takes to cook from scratch every day. That can make it harder to keep daily nutrition balanced — particularly for vitamins and minerals that food alone may not fully cover.

Kidney Vitality is a UK-formulated daily nutritional support product designed by Consultant Nephrologist Professor Mohammed Mahdi Althaf with renal nutrition in mind from the start. It keeps doses moderate, leaves out added potassium, phosphate and magnesium, and avoids megadose vitamin A — sitting alongside a kidney-friendly diet, not replacing it.

Why Kidney Vitality fits this need

Built around UK renal guidance

Aligned with ISPD peritonitis guidelines 2022, UK Renal Association PD standards and NICE NG203.

Designed by a UK Consultant Nephrologist

Formulated and reviewed by Professor Mohammed Mahdi Althaf (GMC 7216325).

Evidence-based by design

Practical, UK NHS PD-unit aligned.

Designed by a UK Consultant Nephrologist

Ready to support your kidney health?

If you have been researching kidney health, supplements, CKD nutrition or kidney-friendly living, Kidney Vitality was developed specifically around those principles by Professor Mohammed Mahdi Althaf (GMC 7216325). Developed using renal nutrition principles.

  • Designed Using Renal Nutrition Principles
  • No Added Potassium
  • No Added Phosphorus
  • Developed by a Consultant Nephrologist
  • One capsule daily
  • UK GMP — BRCGS, NSF GMP, Halal
Subscribe & Save — £20.39/monthCheck your current multivitamin

✓ Free UK tracked delivery  ·  ✓ Delivered every 30 days  ·  ✓ Pause or cancel anytime  ·  ✓ Never run out

ComparisonKidney VitalityTypical high-street multivitamin
Added potassiumNoneOften included
Added phosphateNoneOften included (E338–E452)
Vitamin A (retinol)No megadoseOften high-dose retinol
Kidney-focused formulationYesNo — general population
Consultant Nephrologist involvementYes (GMC 7216325)No
UK GMP manufacturedYes (BRCGS, NSF GMP)Varies

Food supplement. Not a medicine and not a treatment for kidney disease. Speak with your GP, pharmacist or renal team before starting any new supplement, especially in advanced CKD, on dialysis, post-transplant, pregnant or breastfeeding.

Clinical reviewer

Professor Mohammed Mahdi Althaf

Consultant Nephrologist

Acute Physician

GMC 7216325

View Full Biography

Professor Mohammed Mahdi Althaf is a UK Consultant Nephrologist and Acute Physician with a special interest in chronic kidney disease, AKI prevention and renal nutrition. He combines hospital practice with patient education and clinical guidance review.

View professional profile →
View Credentials
  • MD
  • MSc
  • PgDip (Clin Ed)
  • FRCP
  • FHEA
  • FASN

About this article

Written for UK patients and based on:

  • NICE guidance
  • NHS resources
  • British Dietetic Association guidance
  • Kidney Care UK resources
View methodology

Each article is researched against current UK clinical guidance (NICE NG203, NG118, NG136), NHS patient resources, KDIGO and KDOQI international guidelines, and the British Dietetic Association Renal Nutrition Group. Drafts are written by the Kidney Vitality editorial team and reviewed by a UK Consultant Nephrologist before publication. Content is reviewed on a rolling basis and updated when guidance changes.

Editorial standards

  • Clinically reviewed
  • NHS-aligned
  • NICE-aligned
  • Evidence-based
  • Reviewed before publication
View full editorial process

Every article is researched and written by the Kidney Vitality editorial team using current UK clinical guidance (NICE NG203, NG118, NG136), NHS patient resources, KDIGO/KDOQI international guidelines, and British Dietetic Association renal nutrition guidance. Drafts are reviewed for clinical accuracy by Professor Mohammed Mahdi Althaf, MD, MSc, PgDip (Clin Ed), FRCP, FHEA, FASN (Consultant Nephrologist & Acute Physician, GMC 7216325) before publication. Content is updated when UK guidance changes.

References (4)View Sources
  1. NICE NG203: Chronic kidney disease — assessment and management
  2. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of CKD
  3. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update
  4. British Dietetic Association — Renal Nutrition Group

Medical disclaimer

This content is educational only and does not replace personalised medical advice.

Read full disclaimer

This page is general information, not personal medical advice. If you have chronic kidney disease, are on dialysis, have had a kidney transplant, are pregnant or breastfeeding, or take prescription medication, please confirm any supplement with your GP, pharmacist or renal team before starting.

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