Peritoneal dialysis (PD) is a type of dialysis which uses the peritoneum in a person's abdomen as the membrane through which fluid and dissolved substances are exchanged with the blood. It is used to remove excess fluid, correct electrolyte problems, and remove toxins in those with kidney failure. Peritoneal dialysis has better outcomes than hemodialysis during the first couple of years. Other benefits include greater flexibility and better tolerability in those with significant heart disease. Complications may include infections within the abdomen, hernias, high blood sugar, bleeding in the abdomen, and blockage of the catheter. Use is not possible in those with significant prior abdominal surgery or inflammatory bowel disease. It requires some degree of technical skill to be done properly. In peritoneal dialysis, a specific solution is introduced through a permanent tube in the lower abdomen and then removed. This may either occur at regular intervals throughout the day, known as continuous ambulatory peritoneal dialysis (CAPD), or at night with the assistance of a machine, known as automated peritoneal dialysis (APD). The solution is typically made of sodium chloride, bicarbonate, and an osmotic agent such as glucose. The solution used for peritoneal dialysis is on the World Health Organization's List of Essential Medicines. As of 2009, peritoneal dialysis was available in 12 out of 53 African countries. Medical uses Peritoneal dialysis is a method of renal replacement therapy for needing maintenance therapy for late stage chronic kidney disease. This is an alternative to the most common method hemodialysis. Complications Peritoneal Dialysis-Related Peritonitis A common cause of peritonitis is touch contamination, e.g. insertion of catheter by un-sanitized hands, which potentially introduces bacteria to the abdomen; other causes include catheter complication, transplantation of bowel bacteria, and systemic infections. Most common type of PD-peritonitis infection (80%) are from bacterial sources. Infection rates are highly variable by region and within centers with estimated rates between 0.06 - 1.66 episodes per patient year. With recent technical advances peritonitis incidence has decreased overtime. There is not sufficient evidence to be clear about the best treatment for PD-associated peritonitis, although direct infusion of antibiotics into the peritoneum appears to offer slight advantage over the intravenous route of administration; there is no clear advantage for other frequently used treatments such as routine peritoneal lavage or use of urokinase. The use of preventative nasal mupirocin is of unclear effect with respect to peritonitis. Of the three types of