Control of fluid in peritoneal dialysis

Peritoneal dialysis, also known as peritoneal dialysis, is a method of using the patient's peritoneal membrane as a replacement membrane to treat chronic kidney failure, filter metabolites, water, and electrolytes out of the body and help homeostasis.
In peritoneal dialysis, the introduction of water into and out of the body many times will make the patient's homeostasis change and its consequences can lead to lack of fluid or excess fluid for the patient's body. Therefore, in medicine called peritoneal dialysis. Accordingly, the most common disorder in the peritoneal dialysis fluid is excess fluid and this problem needs to be closely monitored and controlled to ensure that the patient has a normal water balance.

In peritoneal dialysis, the frequent introduction of water into and out of the body will cause the patient's homeostasis to change and its consequences can lead to a lack of or an excess of body fluid. sick.
2.1. Evaluation of the patient's epidemic status Assessment of the patient's epidemic status is mainly based on:
Clinical examination; dry weight and change Signs of extracellular fluid retention or dehydration in the patient when assessing fluid status. Patients with weight gain, peripheral edema, hypertension, moist rales at the bottom of the lungs and more severe signs of heart failure, shortness of breath with excess fluid.

2.2. Fluid control in peritoneal dialysis Excess fluid is often due to inappropriate dialysis dose, or the patient does not comply with the treatment regimen, does not adhere to the diet well, due to acute exacerbations of chronic renal failure, causing renal function to persist. The excess is reduced suddenly, in addition, the mechanism of excess fluid is also caused by damage to the peritoneum causing a sudden decrease in filtration capacity. Therefore, it is necessary to examine carefully, comprehensively and simultaneously address many influencing factors to be able to treat this disorder well. Control excess fluid by:
Sodium restriction (salt and water restricted diet, recommended sodium intake is < 100mmol (2.3g) per day); sodium excretion and hypertension in automated peritoneal dialysis. Explain to the patient when to choose high-concentration glucose dialysate. Using a high-glucose dialysis solution will be the primary means of addressing fluid overload. However, high concentrations of glucose should not be abused because it can affect peritoneal dialysis function, increase glucose absorption, worsen glucose and lipid control, and increase obesity. Good blood glucose control, because low blood glucose levels will help create a concentration gradient between the blood compartment and the peritoneal cavity, which is necessary for the elimination of fluid.

Preserve residual kidney function to clear and eliminate fluid. Administration of ACE inhibitors and angiotensin receptor blockers preserves residual renal function, with beneficial effects on both clearance and fluid control, thus maintaining a larger urine volume. However, high doses of loop diuretics should not be used in patients with residual renal function, together with metolazone, because it may increase urine volume and thereby increase fluid excretion. Control of abdominal wall leakage. Management of catheter dysfunction. Preserving peritoneal function by reducing episodes of peritonitis will contribute to preserving peritoneal function. Avoid high-glucose peritoneal dialysis. Control of peritoneal dialysis fluid should be closely monitored and controlled to ensure the patient's normal water balance, minimizing complications during peritoneal dialysis. In order to control the peritoneal dialysis fluid, doctors will perform a clinical examination, evaluate and give appropriate treatment.
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