Peritoneal dialysis (PD) exchanges require sterile equipment, supplies, and technique. Sterility may be maintained with single use. However, when equipment such as lines and transfer sets are used repeatedly, disinfection techniques become a critical aspect in preventing infectious complications. Techniques available for disinfection of lines and transfer sets in PD will be reviewed.

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One measure of peritoneal dialysis (PD) success is a decrease in infection rate. Contaminants from external sources enter the peritoneal cavity via the intra-luminal or peri-luminal paths. Disinfectant can be used to prevent bacteria migration during an exchange due to touch contamination, which would enter along the intra-luminal path or from infections at the exit site, or tunnel, which would enter along the peri-luminal path. Two disinfectants used extensively in PD are povidone-iodine (Betadine) and sodium hypochlorite (Amuchina, Alcavis). Sodium hypochlorite is an electrolytic chloroxidizer, obtained by partial electrolysis of hypertonic sodium chloride containing 11,000 ppm of available free chlorine. The undiluted form of sodium hypochlorite is Amuchina 50%. A diluted form of sodium hypochlorite is Amuchina 10%, ExSept Plus. The solutions are colorless and are transparent liquids. Sodium hypochlorite dissolves in cold water and is decomposed by hot water or carbon dioxide. It is a strong oxidizer, bleaching agent, and sterilizer. At the same time, it is non-toxic and non-irritating. The use of disinfectant to decrease infection by disinfecting PD lines and transfer set will be explored in this section.

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