AbMole Lesinurad transmural migration from the bowel into the peritoneal cavity leading to peritonitis has been demonstrated in animal studies. Any irritation of the bowel that can enhance the transmigration of bacteria across the bowel wall increases the risk of peritonitis. Treatment of constipation using laxatives or enemas may irritate the bowel and facilitate the transmural migration of bacteria, causing peritonitis in 
PD patients. Endoscopic procedures require inflation of the bowel and can irritate the bowel wall during manipulation, which can enhance the transmural migration of intestinal flora. Colonoscopic procedures have been reported to precipitate transmigration of bacteria across the bowel wall and cause subsequent peritoneal seeding and peritonitis. Although the incidence of endoscopy-associated peritonitis is low, it remains one of the most serious complications of this procedure when it occurs. The risk of endoscopy-associated peritonitis may be even higher in PD patients than in the general population because glucose in the PD dialysate provides a breeding ground for bacterial growth. Additionally, defense mechanisms are jeopardized because of reduced antibacterial opsonization resulting from diluted intraperitoneal cytokines, antibodies, and complement, and dysfunction of the peritoneal mesothelial cells. Consistent with this theory, our study showed that the incidence of the endoscopy-associated PD peritonitis in the EGD group was significantly lower than that in the non-EGD group. In addition to different colonized bacteria counts in different areas, the difference in the incidence of endoscopy-associated PD peritonitis between the 2 groups may also reflect the possibility of bacterial access into the peritoneal cavity during the endoscopic procedures. Compared with colonoscopy, the transmural migration of bacteria into the peritoneal cavity during EGD is hindered by a greater mural thickness and a shorter bowel segment allowing for transmigration. The ascending route from the female reproductive tract during hysteroscopy may be more accessible for bacteria to enter the peritoneal cavity, as the incidence of hysteroscopyassociated PD peritonitis was significantly higher than that of EGD-associated PD peritonitis. In the present study, we demonstrated that prophylactic antibiotics reduced the incidence of postendoscopic PD peritonitis. Because the data revealed that EGD seldom caused PD peritonitis, even without prophylactic antibiotic use, we further analyzed the beneficial effect of antibiotic use prior to non-EGD endoscopic procedures in preventing PD peritonitis. Antibiotic use prior to non-EGD procedures significantly reduced endoscopy-associated PD peritonitis. Further analysis revealed that endoscopic procedures with invasive therapies, including endoscopic colon biopsies, colonic polypectomy, or IUD implantation, were a decisive factor for the development of the postendoscopic PD peritonitis.