Indications and contraindications for peritoneal dialysis

Currently, in our country, about 8-10% of the population has end-stage renal failure, so the demand for alternative treatment methods is increasing. In particular, peritoneal dialysis is one of the most favorable treatment methods, ensuring high efficiency. So who are the indications and contraindications for peritoneal dialysis?

The peritoneum is the serosa that covers the abdominal cavity. Accordingly, the peritoneum is divided into two parts: visceral leaves covering the intestines and parietal leaves covering the abdominal wall.
Peritoneal dialysis is a method of using the patient's peritoneal cavity as a replacement membrane for kidney failure, to filter metabolites, water, and electrolytes out of the patient's body and help maintain homeostasis or possibly Infuse the filtrate containing the required amount into the peritoneal cavity and then withdraw it again after a few hours. The principle of peritoneal dialysis is to use the peritoneal peritoneum as a semi-permeable membrane separating the two compartments, one side is the periperitoneal capillaries, the other is the abdominal cavity containing peritoneal filtrate. During peritoneal dialysis, three processes occur: diffusion, ultrafiltration, and absorption.

There are two methods of peritoneal dialysis:
Continuous outpatient peritoneal dialysis is an alternative treatment for patients with end-stage renal failure to remove some metabolic products from the body, and this is also the The method that patients can self-filter at home instead of daily and continuously during the week instead of having to go to the hospital. This method is simple and suitable with low economic conditions for patients. Automated peritoneal peritoneal dialysis is a mechanically-assisted treatment that exchanges filtrate mainly at night. With a frequency of five times in one night.

3.1.Advantages Simple and easy to implement in places where there are no machines and do not depend on machines. Suitable for the elderly, children and even those who are going to school and work. Control of anemia and iron deficiency does not require the use of anticoagulants, thereby reducing the risk of stroke. Peritoneal dialysis changes the solubility of water in the body for patients and is also the method of choice for patients with hemodynamic instability. Peritoneal dialysis gives patients the freedom to perform at home with support and minimal dietary restrictions. 3.2. Cons May increase blood sugar, leak intra-abdominal fluid, easy infection, arrhythmia prone to hypothermia. In addition, endocrine renal function cannot be changed. The possibility of infection is high if the patient does not follow the doctor's instructions when doing it at home.

4.1. Indications for peritoneal dialysis Patients are indicated for peritoneal dialysis in acute renal failure and chronic renal failure and cannot perform artificial techniques. The patient could not create a vascular access for hemodialysis. The state of the heart is not stable, and it is easy to have a stroke when on hemodialysis. 4.2. Contraindications to peritoneal dialysis Patients do not have peritoneal dialysis when the peritoneal cavity is infected, there is a lot of adhesion to the peritoneum, the diaphragm is not tight to overflow into the chest cavity, wide inguinal hernia or because of the ability of the peritoneum to purify. When there is chronic obstructive pulmonary disease because peritoneal dialysis makes it difficult to control the lungs. The patient is unable to do it on her own, has no support for peritoneal dialysis, and is unable to take care of herself. Patients with chronic colitis, inflammatory bowel disease, psychiatric disorders, or recent other abdominal surgery Patients are malnourished or obese.

The steps to perform peritoneal dialysis are as follows:
Step 1: prepare the necessary equipment, tools and machines for peritoneal dialysis Step 2: The doctor makes a clinical examination and makes a dossier to choose the method of implementation. for the patient Step 3: Perform peritoneal procedures Step 4: Take care of the patient after abdominoplasty Step 5: Instruct the patient and the patient on peritoneal dialysis Step 6: The fluid change procedure ( choose a place to change fluid, prepare instruments to change, while changing fluid to ensure accuracy) After performing peritoneal dialysis, follow-up should be carried out as follows:
Check intra-abdominal fluids after filtering. Change the dressing regularly and cut the incision for the patient; Change the patient's fluid regularly. If the patient is treated at home, he/she must guide the patient carefully and recommend a follow-up examination according to the doctor's regulations. To minimize after performing peritoneal dialysis, patients need to maintain a nutritional regimen that meets their recommended energy needs by adding essential nutrients in moderation. regulation. In addition, patients need to eat bland, drink less water, and at the same time avoid foods high in potassium, sugar and salt.
For patients who cannot perform peritoneal dialysis, other renal replacement therapies such as kidney transplantation or hemodialysis will be considered. Patients who are indicated for peritoneal dialysis will be surgically placed into the peritoneal cavity. During peritoneal dialysis, patients need to follow proper technique and ensure hygiene to limit possible complications, especially peritoneal infection.
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