Popular Science Class - What is peritoneal dialysis?

When it comes to uremia, most people know more or less about this disease. It often appears in movies and TV dramas. If it appears, a kidney transplant is necessary to "survive". Then, the patient begins to search the world for a kidney source that matches the patient. Not only is it expensive, but it is also difficult to successfully match. So, does one have to get a kidney transplant if he or she has uremia? In fact, dialysis is also a life-saving method. Dialysis treatment for uremia includes hemodialysis and peritoneal dialysis. Hemodialysis is the main treatment, but it requires patients to travel frequently between home and hospital, which brings a lot of inconvenience to patients. It is also a more "headache" treatment method for patients. Is there no convenient way? Of course there is, that is peritoneal dialysis. So why is peritoneal dialysis more convenient? Today, let's take a look at what peritoneal dialysis is!

Peritoneal dialysis (PD) is a dialysis method that uses the body's own peritoneum as a dialysis membrane. It is usually used for patients with acute and chronic renal failure and has a history of more than 70 years. This method uses the body's own peritoneum as a semi-permeable membrane to remove metabolic products and toxins from the body by regularly and regularly injecting and draining dialysate into the abdominal cavity.

Advantages of peritoneal dialysis:

First, peritoneal dialysis is more flexible and convenient, and the operation process is simple and easy to learn. Patients can complete it independently at home without going to the hospital for treatment, which saves time and treatment costs and reduces the risk of cross-infection. It is especially suitable for office workers and patients who are inconvenient to go to the hospital. Secondly, because peritoneal dialysis uses its own peritoneum as the dialysis membrane, it does not require vascular access operations, which reduces damage and pressure on the vascular system and has certain advantages for patients with vascular diseases. Finally, peritoneal dialysis can remove toxins and waste from the blood more steadily and slowly, and can prevent adverse reactions such as blood pressure fluctuations. It has certain advantages for patients with fragile cardiovascular and cerebrovascular systems.

Disadvantages of peritoneal dialysis:

Since catheters are implanted in the abdominal cavity, peritoneal dialysis patients are at a higher risk of infection. Peritoneal dialysis fluid and catheters may become places for bacteria to grow, requiring strict cleaning and care from patients. In addition, peritoneal dialysis needs to be performed several times a day, each time for several hours, which may affect the daily life of some patients. Peritoneal dialysis patients still need to reasonably adjust their diet and control their fluid intake to avoid nutritional imbalance and edema.

Possible complications of peritoneal dialysis:

Mechanical complications: improper catheter position, catheter blockage or displacement, catheter dislocation, etc.;

Complications of infection: abdominal pain, fever, peritonitis, etc.

Peritoneal dialysis is suitable for patients:

Advanced chronic kidney disease;

Patients with a history of cardiovascular and cerebrovascular disease or unstable cardiovascular status;

Patients who are inconvenient for hemodialysis treatment;

child;

Peritoneal dialysis methods:

Continuous Ambulatory Peritoneal Dialysis (CAPD): Patients undergo peritoneal dialysis 3-5 times a day. CAPD can be completed at home. Although the treatment is frequent, it is more flexible and does not require special equipment or personnel monitoring. The biggest advantage of continuous ambulatory peritoneal dialysis is that the dialysis process is continuous and uninterrupted, and the dialysis time is long, so the removal of medium-weight substances is more sufficient.

Automated Peritoneal Dialysis (APD): Peritoneal dialysis is performed using a peritoneal dialysis machine. Several bags of peritoneal dialysis fluid are connected to the supporting pipes on the machine, and then connected to the peritoneal dialysis tube. After setting the parameters, the peritoneal dialysis machine will change the fluid according to the pre-set settings and automatically complete the dialysis process. The biggest advantage of APD is that the dialysis time can be selected at night, which will not affect normal work and life during the day.

Precautions for peritoneal dialysis **:**

Maintain good hygiene: Before performing peritoneal dialysis, it is important to maintain good hand hygiene and follow proper disinfection procedures.

Regularly replace the dialysis fluid: The dialysis fluid needs to be replaced regularly every day to ensure the effectiveness of dialysis. Patients must follow the advice of their doctors or nurses and replace the dialysis fluid on time. Do not delay or ignore the change of fluid.

Standardized diet: follow the advice of your doctor or nutritionist, pay attention to controlling the intake of fluid, protein, sodium and other elements in your diet, maintain water and electrolyte balance and dialysis effect.

Pay attention to complications: promptly detect and deal with possible complications, such as turbid peritoneal dialysis fluid, infection, poor inflow and outflow, catheter detachment, decreased ultrafiltration, etc. If potential problems or symptoms occur, contact a doctor immediately.

Avoid excessive activity: During peritoneal dialysis, avoid excessive activity or strenuous exercise to prevent traction on the catheter, which may cause it to fall off or other adverse consequences.

Keep an eye on the dialysis process: During peritoneal dialysis, closely observe the color of the dialysate being discharged. If you find any abnormalities, such as blood, pus, or cloudy dialysate, you should inform your doctor immediately.

In short, peritoneal dialysis and hemodialysis are both effective methods for treating uremia. With the continuous development of society, the improvement of quality of life and the extension of life expectancy, chronic diseases such as diabetes and hypertension have gradually replaced chronic nephritis as the main cause of chronic renal failure, while obesity, unhealthy eating habits, staying up late, drug abuse, viral infections, etc., increase the risk of chronic kidney disease. As one of the treatments for end-stage renal disease, peritoneal dialysis is simple and flexible to operate, has little effect on hemodynamics, and has its own advantages, but to achieve the best treatment effect, the joint efforts of patients and medical teams are needed. (Li Kun, Qingdao Branch of Qilu Hospital of Shandong University)