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Understanding peritoneal dialysis

Research 23 May Open Access. Research 24 April Open Access. A new study reports important differences between the characteristics of patients with end-stage renal disease on dialysis who are enrolled in clinical trials worldwide and the general US dialysis population.

These findings highlight the importance of including older patients and those with comorbidities in clinical trials. News and Views 07 January Peritoneal dialysis has many advantages over haemodialysis in the treatment of acute kidney injury AKI in low-resource settings. One limitation, however, is the availability of commercial dialysis fluid.

Peritoneal Dialysis

Following the International Society of Peritoneal Dialysis AKI guidelines, a frontline hospital in Cameroon now shows that locally prepared fluids are safe and effective. Research Highlights 26 May News 06 November Rat studies suggest liposome-supported dialysis could be useful for extracting excess metabolites and drugs from the peritoneal cavity. News and Views 30 September A new study suggests that peritoneal dialysis achieves a favourable mortality outcome compared with haemodialysis for the first 2 years of treatment. However, registry-based comparisons of mortality outcomes in patients with end-stage renal disease on either renal replacement modality are often fraught with complications.

Continuous ambulatory peritoneal dialysis - Kidney Research UK

Before you start peritoneal dialysis you will need an operation to insert the peritoneal catheter, a soft plastic tube that carries the dialysis solution in and out of your abdomen. In children, this is done under general anesthesia, and adults may either receive local anesthetics or general anesthetics for the surgical procedure.

It is best to give your catheter a few weeks to heal before starting dialysis treatments. You will receive intensive training on what the procedure involves and how to use the equipment safely. You will also meet with a dialysis nurse and nutritionist.

Dialysis is a procedure that replaces the function of the kidneys when they stop working properly.

It may be a good idea to also have a family member trained to help you. Be sure to find out your new dietary and fluid restrictions when meeting with the nutritionist. Most centers will admit their patients to the hospital to start dialysis and get on a good schedule that maintains proper labs and fluid balance. The abdomens of some patients, particularly those who are morbidly obese or those with multiple prior abdominal surgeries, may make peritoneal dialysis treatments difficult or even impossible. Cleanliness is a huge factor, and PD requires a sterile environment.

The patient may also experience pain or discomfort if the dialysate is too acidic, too cold or introduced too quickly, while diffuse pain with cloudy discharge may indicate an infection. Severe pain in the rectum or perineum can be the result of an improperly placed catheter. The dwell can also increase pressure on the diaphragm causing impaired breathing, and constipation can interfere with the ability of fluid to flow through the catheter.

A potentially fatal complication estimated to occur in roughly 2.

The fluid used for dialysis uses glucose as a primary osmotic agent, but this may lead to peritonitis , the decline of kidney and peritoneal membrane function and other negative health outcomes. The acidity , high concentration and presence of lactate and products of the degradation of glucose in the solution particularly the latter may contribute to these health issues.

Solutions that are neutral , use bicarbonate instead of lactate and have few glucose degradation products may offer more health benefits though this has not yet been studied. Peritoneal dialysis can be improvised in conditions such as combat surgery or disaster relief using surgical catheters and dialysate made from routinely available medical solutions to provide temporary renal replacement for people with no other options.

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Peritoneal dialysis Diagram of peritoneal dialysis. Archived from the original on World Health Organization. Archived PDF from the original on 13 December Retrieved 8 January Elsevier Health Sciences. Peritoneal dialysis. April Retrieved 8 December International Drug Price Indicator Guide.

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