Which finding signals a significant problem during peritoneal dialysis?

• A. Potassium level of 3.5 mEq/L
• B. Hematocrit of 35%
• C. Blood glucose level of 200 mg/dL
• D. White blood cell count of 20,000 per cubic millimeter

Answer: (D)

In peritoneal dialysis, infections, especially peritonitis, are a major urgent danger. A key sign of trouble is a marked inflammatory response, which shows up as a high white blood cell count. A WBC count of 20,000 per cubic millimeter is far above normal and points to acute infection or inflammation, such as peritonitis or a catheter-related infection. This requires prompt evaluation and treatment to prevent serious complications like sepsis and loss of dialysis effectiveness.

The other values listed don’t convey an acute PD-specific problem as clearly. Potassium at the lower end of normal isn’t by itself an emergency. A hematocrit of 35% indicates anemia but not an immediate PD complication. A blood glucose of 200 mg/dL shows hyperglycemia, which can occur for many reasons but doesn’t signal an acute dialytic complication the way a significantly elevated WBC does.