medical complications of peritoneal dialysis
Last reviewed 01/2018
These include
- peritonitis:
- usually due to poor technique
- routinely culture the drained dialysate
- instill suitable antibiotics if suspected - suitable blind treatment would be vancomycin plus gentamicin, or ceftazidime
- hypovolaemia:
- usually caused by too rapid ultrafiltration - osmolarity of dialysate is too high
- avoid by regularly monitoring weight and blood pressure
- increase intravascular volume with parenteral saline or plasma
- electrolyte disturbance:
- set dialysate composition accordingly
- weight gain, hypertriglyceridaemia and hyperglycaemia:
- due to glucose loading from dialysate
- give small doses of subcutaneous insulin for hyperglycaemia
- protein and amino acid losses:
- provide patient with a high protein diet
- limit duration of dialysis to maximum of 72 hrs weekly
- consider haemodialysis if reduced period of peritoneal dialysis inadequate