Peritoneal Dialysis PD

Question 1

What is peritoneal dialysis?

Answer 1

Peritoneal dialysis (PD) is a form of renal replacement therapy that uses the patient’s peritoneal membrane as a semi-permeable membrane to exchange waste products and excess fluids from the blood.

Question 2

How does peritoneal dialysis work?

Answer 2

A dialysis solution is infused into the peritoneal cavity, where waste products and excess electrolytes diffuse across the peritoneal membrane into the solution, which is then drained and replaced.

Question 3

What are the main types of peritoneal dialysis?

Answer 3

The main types are Continuous Ambulatory Peritoneal Dialysis (CAPD), where exchanges are done manually throughout the day, and Automated Peritoneal Dialysis (APD), which uses a machine to perform exchanges, typically overnight.

Question 4

What is a Tenckhoff catheter?

Answer 4

A Tenckhoff catheter is a flexible silicone tube with multiple pores on the intra-abdominal portion, used to access the peritoneal cavity for dialysis.

Question 5

How is a Tenckhoff catheter placed?

Answer 5

It can be implanted using open surgical, laparoscopic, or percutaneous techniques, with no strong evidence favoring one method over another.

Question 6

What are the advantages of peritoneal dialysis over haemodialysis?

Answer 6

Advantages include greater flexibility and independence, no need for vascular access, and more stable fluid and electrolyte balance.

Question 7

What are common complications associated with peritoneal dialysis?

Answer 7

Complications can include peritonitis, catheter-related infections, hernias, and membrane failure over time.

Question 8

How is peritonitis diagnosed in peritoneal dialysis patients?

Answer 8

Diagnosis is based on clinical symptoms like abdominal pain and cloudy dialysis effluent, along with laboratory analysis showing elevated white cell count in the effluent.

Question 9

What are the signs of a catheter-related infection in peritoneal dialysis?

Answer 9

Signs include redness, swelling, pain, or discharge at the catheter exit site, which may indicate infection.

Question 10

How often are exchanges typically performed in Continuous Ambulatory Peritoneal Dialysis (CAPD)?

Answer 10

Exchanges are usually performed four times a day, with each exchange taking about 30 minutes.

Question 11

What lifestyle considerations should patients on peritoneal dialysis be aware of?

Answer 11

Patients should maintain good hygiene, adhere to a sterile technique during exchanges, and manage their dialysis schedule around daily activities.

Question 12

How does Automated Peritoneal Dialysis (APD) differ from CAPD?

Answer 12

APD uses a machine to perform exchanges overnight while the patient sleeps, offering more flexibility during the day compared to CAPD.

Question 13

What dietary restrictions are typically recommended for peritoneal dialysis patients?

Answer 13

Patients may need to limit sodium, potassium, and phosphorus intake, and monitor fluid intake, while ensuring adequate protein consumption.

Question 14

How does peritoneal dialysis affect glucose levels in diabetic patients?

Answer 14

The dialysis solution contains glucose, which can be absorbed and may affect blood sugar levels, requiring adjustments in diabetic management.

Question 15

What is the role of the peritoneal membrane in peritoneal dialysis?

Answer 15

The peritoneal membrane acts as a natural filter, allowing waste products and excess fluids to pass from the blood into the dialysis solution.

Question 16

How can patients prevent peritonitis while on peritoneal dialysis?

Answer 16

Preventive measures include strict adherence to sterile techniques during exchanges, proper hand hygiene, and regular monitoring for signs of infection.

Question 17

What is the typical dwell time for dialysis solution in peritoneal dialysis?

Answer 17

Dwell time varies but typically ranges from 4 to 6 hours during the day for CAPD, and longer overnight for APD.

Question 18

How is ultrafiltration achieved in peritoneal dialysis?

Answer 18

Ultrafiltration is achieved by using dialysis solutions with varying glucose concentrations, creating an osmotic gradient that draws excess fluid from the blood into the peritoneal cavity.

Question 19

What factors influence the choice between peritoneal dialysis and haemodialysis for a patient?

Answer 19

Factors include the patient’s medical condition, lifestyle preferences, home environment, and personal choice, often guided by discussions with the healthcare team.

Question 20

How does peritoneal dialysis impact a patient’s daily life and work schedule?

Answer 20

Peritoneal dialysis offers flexibility, allowing patients to perform exchanges at home or work, and schedule treatments around their daily activities.

Question 21

What is the significance of the peritoneal equilibration test (PET) in peritoneal dialysis?

Answer 21

The PET assesses the transport characteristics of the peritoneal membrane, helping to tailor dialysis prescriptions to individual patient needs.

Question 22

How can patients manage the common side effect of bloating during peritoneal dialysis?

Answer 22

Patients can manage bloating by adjusting the volume of dialysis solution, ensuring proper catheter placement, and discussing concerns with their healthcare provider.

Question 23

What psychological support options are available for patients undergoing peritoneal dialysis?

Answer 23

Support options include counseling services, support groups, and mental health professionals experienced in dealing with chronic illness.

Question 24

How is adequacy of peritoneal dialysis measured?

Answer 24

Adequacy is assessed by measuring solute clearance, often using parameters like Kt/V and creatinine clearance, to ensure effective treatment.

Question 25

What are the potential long-term complications of peritoneal dialysis?

Answer 25

Long-term complications can include peritoneal membrane failure, leading to reduced dialysis effectiveness, and encapsulating peritoneal sclerosis, a rare but serious condition.