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KEY FACTS
Preprocedure
Procedure
Post Procedure
Outcomes
TERMINOLOGY
Abbreviations
- Peritoneal dialysis (PD)
Definitions
- Mechanism of action
- Movement of solutes and water between 2 compartments across semipermeable membrane (peritoneal lining)
- Surface area of peritoneal membrane is 1-2 m²
- 1 compartment is peritoneal capillary bed
- High concentration of uremic toxins
- Blood flow via inferior epigastric, intercostal, and lumbar arteries
- Other component is peritoneal cavity
- Where PD solution (dialysate) is infused
- Solutes
- Move down concentration gradients via diffusion
- Urea and potassium move from high concentration in peritoneal capillary bed to low concentration dialysate in peritoneal cavity
- Moved via convection (a.k.a. solute drag)
- Movement of solutes with water (small proteins)
- Move down concentration gradients via diffusion
- Water
- Moves across membrane in response to osmotic/colloid gradient force
- Dialysate hypertonic/hypercolloid
- Pulls water from peritoneal capillary bed to peritoneum
- Moves across membrane in response to osmotic/colloid gradient force
- Movement of solutes and water between 2 compartments across semipermeable membrane (peritoneal lining)
- Utilization
- PD utilized as renal replacement therapy (RRT) in ~ 200,000 end-stage renal disease (ESRD) patients
- 9.5% of patients in USA; 11% of patients worldwide
- Advantages c/w hemodialysis (HD)
- Lower cost
- Fewer hospitalizations
- Lower need for interventions to maintain access
- Greater patient independence
- Greater autonomy of care
- Lower potential for infectious disease outbreak c/w HD
- HIV/hepatitis outbreaks at HD centers
- No need for subsequent needle sticks after placement
- Survival advantage
- Better preservation of residual kidney function
- Preservation of endocrine and metabolic function
- Some residual kidney function preserves Na+ and water clearance
- No access-related heart failure
- No hypotension during HD (intradialytic hypotension)
- Can cause myocardial stunning
- Better preservation of residual kidney function
- Better lifestyle
- No need for frequent travel to HD center
- Less prohibitive dietary considerations
- Can travel/vacation more easily
- Mechanism of action
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Alternative Procedures/Therapies
POST PROCEDURE
Things to Do
Things to Avoid
OUTCOMES
Problems
Complications
Expected Outcomes
Selected References
- Esagian SM et al: Surgical versus percutaneous catheter placement for peritoneal dialysis: an updated systematic review and meta-analysis. J Nephrol. 34(5):1681-96, 2021
- Ma Y et al: Association between different peritoneal dialysis catheter placement methods and short-term postoperative complications. BMC Nephrol. 22(1):151, 2021
- Zang Z et al: Different techniques for peritoneal dialysis catheter implantation: a systematic review and network meta-analysis. Perit Dial Int. 41(6):522-32, 2021
- Zou Y et al: Assessment of complications and short-term outcomes of percutaneous peritoneal dialysis catheter insertion by conventional or modified Seldinger technique. Ren Fail. 43(1):919-25, 2021
- Morris CS: Interventional radiology placement and management of tunneled peritoneal dialysis catheters: a pictorial review. Radiographics. 40(6):1789-806, 2020
- Crabtree JH et al: Creating and maintaining optimal peritoneal dialysis access in the adult patient: 2019 update. Perit Dial Int. 39(5):414-36, 2019
- Tanasiychuk T et al: The ideal position of the peritoneal dialysis catheter is not always ideal. Int Urol Nephrol. 51(10):1867-72, 2019
- Lee J et al: Radiological Tenckhoff catheter insertion for peritoneal dialysis: a cost-effective approach. J Med Imaging Radiat Oncol. 62(2):174-8, 2018
- Crabtree JH et al: Peritoneal dialysis catheter insertion. Semin Nephrol. 37(1):17-29, 2017
- Crabtree JH: Peritoneal dialysis catheter implantation: avoiding problems and optimizing outcomes. Semin Dial. 28(1):12-5, 2015
- Gallieni M et al: Type of peritoneal dialysis catheter and outcomes. J Vasc Access. 16 Suppl 9:S68-72, 2015
- Abdel-Aal AK et al: Best practices consensus protocol for peritoneal dialysis catheter placement by interventional radiologists. Perit Dial Int. 34(5):481-93, 2014
- Bagul A et al: Laparoscopic peritoneal dialysis catheter (PDC) insertion: does it really make a difference? J Nephrol. 27(2):127-34, 2014
- Kuru S et al: Sclerosing encapsulating peritonitis with perforation of the gastrointestinal tract: a serious complication of continuous peritoneal dialysis. Ann Saudi Med. 32(6):660-1, 2012
- Singh SK et al: Peritoneal dialysis catheter malfunction because of encasement by an extraluminal fibrin sheath. Perit Dial Int. 32(2):218-20, 2012
- Dell'Aquila R et al: Rational choice of peritoneal dialysis catheter. Perit Dial Int. 27 Suppl 2:S119-25, 2007
- Rabindranath KS et al: Automated vs continuous ambulatory peritoneal dialysis: a systematic review of randomized controlled trials. Nephrol Dial Transplant. 22(10):2991-8, 2007
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References
Tables
Tables
KEY FACTS
Preprocedure
Procedure
Post Procedure
Outcomes
TERMINOLOGY
Abbreviations
- Peritoneal dialysis (PD)
Definitions
- Mechanism of action
- Movement of solutes and water between 2 compartments across semipermeable membrane (peritoneal lining)
- Surface area of peritoneal membrane is 1-2 m²
- 1 compartment is peritoneal capillary bed
- High concentration of uremic toxins
- Blood flow via inferior epigastric, intercostal, and lumbar arteries
- Other component is peritoneal cavity
- Where PD solution (dialysate) is infused
- Solutes
- Move down concentration gradients via diffusion
- Urea and potassium move from high concentration in peritoneal capillary bed to low concentration dialysate in peritoneal cavity
- Moved via convection (a.k.a. solute drag)
- Movement of solutes with water (small proteins)
- Move down concentration gradients via diffusion
- Water
- Moves across membrane in response to osmotic/colloid gradient force
- Dialysate hypertonic/hypercolloid
- Pulls water from peritoneal capillary bed to peritoneum
- Moves across membrane in response to osmotic/colloid gradient force
- Movement of solutes and water between 2 compartments across semipermeable membrane (peritoneal lining)
- Utilization
- PD utilized as renal replacement therapy (RRT) in ~ 200,000 end-stage renal disease (ESRD) patients
- 9.5% of patients in USA; 11% of patients worldwide
- Advantages c/w hemodialysis (HD)
- Lower cost
- Fewer hospitalizations
- Lower need for interventions to maintain access
- Greater patient independence
- Greater autonomy of care
- Lower potential for infectious disease outbreak c/w HD
- HIV/hepatitis outbreaks at HD centers
- No need for subsequent needle sticks after placement
- Survival advantage
- Better preservation of residual kidney function
- Preservation of endocrine and metabolic function
- Some residual kidney function preserves Na+ and water clearance
- No access-related heart failure
- No hypotension during HD (intradialytic hypotension)
- Can cause myocardial stunning
- Better preservation of residual kidney function
- Better lifestyle
- No need for frequent travel to HD center
- Less prohibitive dietary considerations
- Can travel/vacation more easily
- Mechanism of action
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Alternative Procedures/Therapies
POST PROCEDURE
Things to Do
Things to Avoid
OUTCOMES
Problems
Complications
Expected Outcomes
Selected References
- Esagian SM et al: Surgical versus percutaneous catheter placement for peritoneal dialysis: an updated systematic review and meta-analysis. J Nephrol. 34(5):1681-96, 2021
- Ma Y et al: Association between different peritoneal dialysis catheter placement methods and short-term postoperative complications. BMC Nephrol. 22(1):151, 2021
- Zang Z et al: Different techniques for peritoneal dialysis catheter implantation: a systematic review and network meta-analysis. Perit Dial Int. 41(6):522-32, 2021
- Zou Y et al: Assessment of complications and short-term outcomes of percutaneous peritoneal dialysis catheter insertion by conventional or modified Seldinger technique. Ren Fail. 43(1):919-25, 2021
- Morris CS: Interventional radiology placement and management of tunneled peritoneal dialysis catheters: a pictorial review. Radiographics. 40(6):1789-806, 2020
- Crabtree JH et al: Creating and maintaining optimal peritoneal dialysis access in the adult patient: 2019 update. Perit Dial Int. 39(5):414-36, 2019
- Tanasiychuk T et al: The ideal position of the peritoneal dialysis catheter is not always ideal. Int Urol Nephrol. 51(10):1867-72, 2019
- Lee J et al: Radiological Tenckhoff catheter insertion for peritoneal dialysis: a cost-effective approach. J Med Imaging Radiat Oncol. 62(2):174-8, 2018
- Crabtree JH et al: Peritoneal dialysis catheter insertion. Semin Nephrol. 37(1):17-29, 2017
- Crabtree JH: Peritoneal dialysis catheter implantation: avoiding problems and optimizing outcomes. Semin Dial. 28(1):12-5, 2015
- Gallieni M et al: Type of peritoneal dialysis catheter and outcomes. J Vasc Access. 16 Suppl 9:S68-72, 2015
- Abdel-Aal AK et al: Best practices consensus protocol for peritoneal dialysis catheter placement by interventional radiologists. Perit Dial Int. 34(5):481-93, 2014
- Bagul A et al: Laparoscopic peritoneal dialysis catheter (PDC) insertion: does it really make a difference? J Nephrol. 27(2):127-34, 2014
- Kuru S et al: Sclerosing encapsulating peritonitis with perforation of the gastrointestinal tract: a serious complication of continuous peritoneal dialysis. Ann Saudi Med. 32(6):660-1, 2012
- Singh SK et al: Peritoneal dialysis catheter malfunction because of encasement by an extraluminal fibrin sheath. Perit Dial Int. 32(2):218-20, 2012
- Dell'Aquila R et al: Rational choice of peritoneal dialysis catheter. Perit Dial Int. 27 Suppl 2:S119-25, 2007
- Rabindranath KS et al: Automated vs continuous ambulatory peritoneal dialysis: a systematic review of randomized controlled trials. Nephrol Dial Transplant. 22(10):2991-8, 2007
