Peritoneal Dialysis
What is Peritoneal Dialysis?
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Peritoneal dialysis is a treatment method that treats kidney failure by using the patient's peritoneal membrane as a filter.
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Peritoneal dialysis solution is administered to the abdomen through a catheter placed in the patient's abdominal cavity.
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Wait for a while. During this waiting period, the abdominal membrane acts as a filter. The blood is cleaned by the passage of toxic substances between the patient's blood and the dialysis solution. Excess fluid in the body attracts excess fluid due to the sugary nature of the solution.
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Then the fluid in the abdomen is drained. Thus, toxic substances and excess fluid are removed from the body.
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Who Should Prefer?
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Children
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Those with serious cardiovascular disease
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Patients who cannot receive vascular access for hemodialysis
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Patients for whom it is difficult to reach the hemodialysis center
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Patients with bleeding tendency
Who is it not recommended for?
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Abdominal problems: Inflammatory bowel diseases, abdominal abscess, intra-abdominal adhesions
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Advanced COPD
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hernias
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in obese patients
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hygiene problem
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Psychological Problems
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Mental Problems
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Pregnancy
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Patients who will soon undergo kidney transplantation
What are the advantages?
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Fewer dietary restrictions are required.
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It provides easier blood pressure control than hemodialysis.
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Performing the treatment by the patient himself gives the patient the opportunity to organize his own treatment hours.
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Since the treatment is done at home, it saves you from having to travel to a center.
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The load on the cardiovascular system is less.
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What are the drawbacks and risks?
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Application frequency is high. Peritoneal dialysis needs to be performed 3-5 times every day.
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The patient must live with a catheter in his abdomen.
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Patient's compliance with treatment: The patient must personally apply the treatment and take responsibility.
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Risk of peritonitis
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catheter infection
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Hernia Development
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Protein Loss
Why is training necessary for Peritoneal Dialysis?
In order to apply this treatment at home, the patient or his/her relatives must receive training on this subject. Training is given by peritoneal dialysis nurses under the control of nephrologists. The main topics in education are:
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Making connections for dialysis process
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Use of the dialysis machine
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Catheter care
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Monitoring vital signs such as blood pressure, pulse and temperature
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Determining possible problems and what to do in this situation
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Record keeping
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Diet
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Drugs to be used
How will your follow-ups be done?
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Follow-ups are necessary to ensure the effectiveness and continuity of the treatment of patients on peritoneal dialysis.
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Do not forget to bring exchange solutions, peritoneal dialysis record book and necessary materials with you during the control.
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Follow-ups are done in peritoneal dialysis centers where there is a nephrologist.
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Your blood pressure, pulse, temperature and weight are monitored. You will be examined for edema and infection.
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Necessary tests are performed on blood and fluid taken from the peritoneum.
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It is decided whether sufficient dialysis has been performed.
Monitoring Peritoneal Dialysis Adequacy
There are 3 criteria to evaluate whether the patient has sufficient dialysis:
1- Clinical Evaluation: It is evaluated how the patient feels, blood pressure values, the patient's weight, whether there are complaints such as edema and shortness of breath.
2- Biochemical evaluation: It is the evaluation of the patient with tests such as hemogram, urea-creatinine values, Albumin and Calcium.
3- The effectiveness of peritoneal dialysis is decided with more complex and mathematical measurements. These are examinations such as Kt/V, Creatinine clearance, PET (Peritoneal Synchronization Test).
What is a Peritoneal Dialysis Room?
Continuous Ambulatory Peritoneal Dialysis is the room where the patient is performed. Ideally, a separate room should be reserved for this treatment. The patient's bedroom is used as the peritoneal room with instruments.
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What are the Features of Peritoneal Dialysis Room?
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Lighting and ventilation should be sufficient.
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It is preferred that the room receives sunlight.
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There should be no unused items in the room.
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It should also not be used for other purposes (living room, dining room, guest room, etc.).
Why are home visits made?
One of the most important issues of peritoneal dialysis is home visits.
Home visits are planned before the patient starts peritoneal dialysis, immediately after starting treatment, and subsequently with sufficient frequency according to the patient's needs.
Home visits are planned and carried out by the peritoneal dialysis nurse.
The following situations are examined through home visits:
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Family's perspective on the patient
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Communication level between patient and family
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Family support for peritoneal dialysis
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Physical and equipment of the peritoneal dialysis room
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Whether the patient performed the treatment in accordance with the trainings
