Kidney disease knowledge | Precautions related to peritoneal dialysis

Peritoneal dialysis is one of the commonly used methods of renal replacement therapy for end-stage renal disease (uremia). It uses the body's own peritoneum as a semipermeable membrane and continuously replaces the peritoneal dialysis fluid to remove metabolic products and toxic substances in the body and correct water and electrolyte imbalances, thereby achieving the purpose of treating uremia.

Advantages of peritoneal dialysis

1. Protecting residual renal function: Protecting residual renal function is crucial to improving dialysis effects, reducing complications, improving symptoms, and increasing survival rates. For patients with residual renal function, peritoneal dialysis is recommended as the first choice if there are no contraindications;

2. Peritoneal dialysis is more suitable for patients with more complex hemodynamics (such as heart failure) because it has less impact on hemodynamics;

3. Home dialysis is not affected by traffic, shortens the time patients spend traveling between the hospital and home, and has little impact on patients' study, work, life and family;

4. Peritoneal dialysis does not require the establishment of vascular access and is suitable for uremic patients with poor vascular conditions;

5. No risk of infection with blood-borne infectious diseases such as hepatitis, AIDS, syphilis, etc.;

6. No anticoagulation is required during peritoneal dialysis, and the risk of bleeding is low, which is suitable for patients with bleeding tendency;

7. In addition to its own cost being lower than hemodialysis, peritoneal dialysis can also reduce the cost of patient care and travel to and from the hospital, and its indirect medical costs are also lower than hemodialysis.

Preoperative preparation

1. Bowel preparation: If the patient is constipated or has not defecated for a long time, enema can be performed 4 to 6 hours before surgery;

2. Empty the bladder before surgery: to prevent the bladder from being overfilled, which may cause trouble in catheterization;

3. Anticoagulants increase the risk of surgical bleeding. Oral aspirin should be discontinued for 1 week, and oral warfarin should be discontinued for 3 days.

4. Do not eat for 12 hours and do not drink water for 4 hours before surgery;

5. Keep warm before surgery to avoid colds, fever, etc.;

6. Relax your mind and try not to be anxious or nervous.

Postoperative Care

1. Postoperative diet: While focusing on supplementing protein and vitamins, patients should also consume more crude fiber foods to avoid constipation;

2. Maintain smooth bowel movements: Maintain good bowel habits and take laxatives or enema if necessary;

3. Encourage patients to get out of bed and move around early after surgery to promote gas and defecation and avoid thrombosis in the lower limbs;

4. Change the dressing every 3 days after surgery. If the dressing is bleeding, exuding, sweating, or the wound is contaminated, the dressing should be changed in time. The stitches should be removed 10 days after surgery;

5. Pay attention to catheter fixation within 2 weeks after surgery to avoid pulling the catheter. The abdominal band should be tied with appropriate tightness to protect the wound and maintain the catheter in a reasonable position;

6. Keep the catheter outlet dry, and avoid bathing and swimming. Six weeks after the operation, if the wound heals well, you can take a shower, but you should pay attention to protect the outlet from contact with water. After the shower, the outlet should be cleaned and disinfected in time;

7. The exposed conduit and the connecting pipe should be tightly connected to avoid falling off. Do not touch sharp objects such as scissors when maintaining the exposed conduit and the connecting pipe;

8. The short connecting tube must be replaced every 3 to 6 months. If it is damaged or the switch fails, it should be replaced immediately. If the patient finds that the catheter is damaged or leaking during home dialysis, the infusion of dialysis fluid should be stopped and the patient should go to the peritoneal dialysis center for treatment immediately;

9. Pay attention to how the nurse performs peritoneal dialysis fluid replacement and catheter exit care, and learn various nursing care under the guidance of the nurse;

10. When operating at home, you should pay strict attention to hand hygiene and the cleanliness of the surrounding environment.