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Patient Care - Peritoneal Dialysis
Peritoneal dialysis is a simple surgical procedure in
which a dialyzing solution is placed in the peritoneal cavity, through a
catheter with perforations, to remove urea, other nitrogenous wastes,
electrolytes, water, and other substances across the peritoneal membrane, using
the principles of diffusion and osmosis. The process of peritoneal dialysis is
similar to that of hemodialysis. However, in hemodialysis, the blood circulates
through an artificial membrane of cellophane or Cuprophane in a dialysis
apparatus (artificial kidney) such as the kiil type with its horizontal
dialyzing plates, or a coil type. Peritoneal dialysis is technically simpler
than hemodialysis. It does not require highly trained personnel and can be
started in minutes, even during preparation for hemodialysis. It avoids the
dangers of hemodialysis such as hemorrhage from heparin, air embolism,
hemolysis, transfusion hepatitis, etc. Serious changes in plasma volume are
less frequent with peritoneal dialysis than with hemodialysis. It is also
preferable to hemodialysis if anticoagulation would be dangerous, such as
inactive hemorrhage, ulcer of the stomach, extensive trauma or chest surgery,
or bleeding disorder. However, it is less effective than hemodialysis and takes
from 3 to 6 times as long t5o achieve similar results. The dialysis
disequilibrium syndrome occurs less frequently after peritoneal dialysis than
after hemodialysis is preferable to peritoneal dialyzable drug or poison is
present, and for renal failure complicated by an increased metabolic state,
associated with fever, for example. It is also preferable in diabetics, because
a large amount of dextrose is needed in the peritoneal dialysis solution.
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