Objectives: Whereas several factors interact to influence repeat peritonitis in associated peritoneal dialysis (PD), weather conditions have been inadvertently overlooked in the sense that they may have an indirect influence. Likewise, it’s hard to figure out what the winter problems are for this issue. Furthermore, there has been little study on this effect, even if it has never been done before in cold areas of Thailand (especially the north and northeast) where winter temperatures dip as low as single-digit temperatures on the Celsius scale. We looked at the epidemiology and also learned more about how the cold season affects the number of times patients with PD have peritonitis. Methods: Based on a mixed methods design, conducted quantitative first and followed by qualitative in 2018-2020. In quantitative methodology, a retrospective chart review was conducted. The latter was formulated in accordance with grounded theory. Participants were recruited by snowball sampling. By using semi-structured interviews, data triangulation was then used to gather broad information from the stakeholders (patients and then their caregivers). Developing themes were applied through the NVivo program. Results: With 49 patients in whom 100 peritonitis episodes occurred, the odds of repeated infection during the winter months were 1.89 times greater than during the hot season. While the data deductively extracted themes, the effects were as follows: technical and personal functioning (difficulties), acclimatization (often used rewarming techniques passively rather than actively) and emotional state. Conclusions: Despite being statistically inconclusive, exposure to cold weather might be a magnified problem for performing PD, which is justified by the probability of multiple peritonitis episodes of nearly 90 percent. It's important to look at both positive and negative acclimatization, as well as problems and passive rewarming methods, when combining qualitative data. Repeating peritonitis can be caused by both positive and negative acclimatization.