Peritoneal dialysis for the treatment of acute renal failure

Posted by e-Medical PPT Saturday, August 21, 2010
Peritoneal dialysis (PD) is a process uses the patient's peritoneum in the abdomen as a membrane across which fluids and dissolved substances are exchanged from the blood. Two major types of peritoneal dialysis that continuous ambulatory peritoneal dialysis (CAPD), and continuous cycling peritoneal dialysis (CCPD).PD is used as an alternative to hemodialysis though it is far less common. It has comparable risks and expenses, with the primary advantage being the ability to undertake treatment without visiting a medical facility.
The fluid used typically contains sodium, chloride, lactate or bicarbonate and a high percentage of glucose to ensure hyperosmolarity.A large volume of fluid is introduced to the abdomen via catheter.The total volume is referred to as a dwell and the fluid itself is referred to as dialysate.The dwell remains in the abdomen and waste products diffuse across the peritoneum from the underlying blood vessels.After 4-6 hours, the fluid is removed and replaced with fresh fluid.
PD is less efficient at removing wastes from the body than hemodialysis, and the presence of the tube presents a risk of peritonitis due to the potential to introduce bacteria to the abdomen.And recurrent or non resolving episodes of peritonitis can result in Encapsulating Peritoneal Sclerosis(very rare complication). Excessive loss of fluid can result in hypovolemic shock or hypotension while excessive fluid retention can result in hypertension and edema.

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