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What is peritoneal dialysis?
Peritoneal Dialysis
The abdominal organs are covered by a thin membrane called peritoneum. An empty space exists between the abdominal organs called peritoneal cavity. Peritoneal Dialysis is performed by introducing a dextrose and salt solution into the peritoneal cavity. Waste material and water moves across the peritoneal membrane into this fluid which is drained out.
What is the physiological basis for performing peritoneal dialysis?
Two main ways in which dialysis takes place in peritoneal dialysis.
- Diffusion.
- Ultra filtration.
Diffusion: Diffusion is the principal mechanism in which peritoneal dialysis removes waste products. It is the process in which the peritoneal membrane acts as an semi permeable membrane and diffusion occurs down the concentration bleeding from the blood into the dialysis solution.
Ultra filtration : Ultra filtration is defined as the movement of water across semi permeable. Ultra filtration is the mechanism where by fluid is removed in Peritoneal Dialysis. The dialysis solutions contains glucose and this acts as an effective osmotic agent to draw water across the semi permeable membrane. Along with water some solutes are dragged across.
What is the typically composition of dialysis solution for Peritoneal Dialysis?
The Dialysis solution normally contains:
Sodium:
132 miliquirents /liter Potassium zero. It is added as needed Chloride 96 to 102 miliquirents /liter, Calcium 3.5 or 2.5 miliquirents /liter, Magnesium 0.5 or 1.5 miliquirents /liter.
Bicarbonate is in the form of lactate. The normal dialysis solution lactate is 35 to 40 miliquirents /liter Glucose in the form as dextrose
How is peritoneal dialysis done?
Peritoneal dialysis requires the insertion of a catheter into the abdomen. Peritoneal dialysis solution, which is provided in plastic bags (Usually 2 – 2.5L at a time) is connected to the catheter and fluid is inserted into the abdomen. The fluid is allowed to remain in the abdomen for some time after which it is drained out.
What is an exchange in peritoneal dialysis?
First, any residual fluid in the abdomen is drained out. The bag containing the PDExchange in Peritonial Dialysis fluid is then connected to the catheter and fluid is allowed to run in. The bag is disconnected from the catheter (possible with Y–set). This is called an exchange. The fluid is allowed to remain in the abdomen for a few hours before it is drained out again.
How much time is required to do an exchange?
Usually about 30–45 min.
What is CAPD?
CAPD is Continuous Ambulatory Peritoneal Dialysis. PD fluid is always present in the abdomen. Typically 4–5 exchanges are done during the daytime. The abdomen is left filled with peritoneal dialysis fluid overnight and drained out in the morning.