Today our topic of discussion is Peritoneal Dialysis.
Peritoneal Dialysis
PERITONEAL DIALYSIS
Definition
Peritoneal dialysis involves repeated cycles of instilling dialysis into the peritoneal cavity, allowing time for substance exchange, and then removing the dialysate.
Purpose
- To remove the end products of protein metabolism such
- as urea and creatinine from the blood
- To maintain the safe concentration of seroelectrolytes
- To correct acidosis and replenish the bloods bicarbonate buffer system
- To remove excess fluid from the blood.
Indications
- Peritoneal dialysis is indicated for patients with:
- Chronic renal failure
- Cardiovascular instability
- Vascular access problems that prevent hemodialysis,
- fluid overload or electrolyte imbalance It has been used for overdose of drugs and toxins.
Advantage
One of the primary advantages of peritoneal dialysis is its relative indication which allows it to be used in community healthcare facilities without all the sophisticated equipment needed for dialysis It can be easily managed at home and often provide the client more independent and mobility and hemodialysis.
Principles of Peritoneal Dialysis (Fig. 29.110)
- Diffusion: In diffusion, particles move through a semi- permeable membrane from an area of high-solute concentration to an area of low solute concentration.
- In peritoneal-dialysis, the water-based dialysate being infused contains glucose, sodium chloride, calcium, magnesium, acetate or lactate and no waste products.
- Therefore, the waste products and excess electrolytes in the blood cross in the semi-permeable peritoneal membrane into the dialysate (Fig. 29.111).
- Osmosis: In osmosis the fluids move through a semi- permeable membrane from an area of low solute concentration to an area of high solute concentration.
- In peritoneal-dialysis dextrose is added to the dialysate to give it a higher solute concentration, then the blood, creating a high osmotic gradient.
- Water migrates from the blood through the membrane at the beginning of each infusion which the osmotic gradient is highest (Fig. 29.112).
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