HealthMedicine

Peritoneal dialysis in the treatment of kidney disease

Peritoneal dialysis - this is one of the methods of substitution treatment for impaired renal function. The principle of this type of therapy is the diffusion exchange of low-molecular and medium-molecular substances and fluid, through the membrane lining the abdominal cavity and its organs, from the blood, into a special solution poured into the abdominal cavity. For the first time successful peritoneal dialysis was applied in 1945 for the treatment of acute renal failure.

In order to understand what is dialysis of the kidneys or, more correctly, dialysis of blood, it is necessary to know the pathophysiological processes that take place in the body in diseases of the kidneys.

Peritoneal dialysis is used to treat acute and chronic kidney failure.

The main diseases leading to the development of chronic kidney failure are glomerulonephritis, pyelonephritis, systemic diseases, kidney stones, diabetes, congenital anomalies in the development of the genitourinary system, etc. Acute insufficiency occurs with shock conditions, severe hemorrhagic fever, obstetric and surgical pathology. In this case, the basic functions of the kidneys are broken - excretory and metabolic, which maintains a balance of the electrolyte balance. There is a retention of fluid and slags, which are normally excreted by the kidneys from the body. In order to resolve this situation, in addition to drug therapy, hemodialysis and peritoneal dialysis are used, due to which excess fluid and toxins are removed.

As mentioned above, the essence of peritoneal dialysis is based on the diffuse mechanism of transfer of toxins from one medium to another. In the human body, these media is a special sterile solution, poured into the patient's abdominal cavity and blood. When hemodialysis, which is carried out on the apparatus "artificial kidney", the exchange between blood and solution occurs through the synthetic membrane of the dialyzer. And with peritoneal dialysis, the role of this membrane is performed by its own peritoneum (the membrane covering the abdominal cavity). Human peritoneum is capable of passing molecules of small mass. Slags from the blood, where their content in renal insufficiency is high, penetrate through the pores into the solution, due to the difference in concentration. Since the peritoneal solution contains glucose in its composition, which is capable of attracting water, the excess liquid is removed.

Peritoneal dialysis is performed by pouring into the abdominal cavity a special sterile solution in a volume of 2.5 liters (for an adult person), through a special catheter installed in the abdominal cavity. After about 5 hours, the fluid from the abdominal cavity is drained and replaced with a new one. During the day, there are 4-5 shifts. The number of shifts depends on the patient's condition and the quality of the exchange function of the peritoneum, which is controlled by indicators of the biochemical blood test.

Who is indicated for peritoneal dialysis?

Peritoneal dialysis is carried out in patients with serious heart disease, sick children and the elderly. Since it can be carried out by the patient on its own, it is suitable for patients living away from the centers of hemodialysis.

The catheter is placed in the abdominal cavity in the hospital, in the operating room. Further, the patient is taught the independent procedure, the selection of shifts and dialysis solution. Approximately in 2-3 weeks the patient is discharged home, where he independently performs all manipulations. The patient visits the dialysis department once a month to take the necessary tests and to obtain solutions. This applies to people with chronic kidney failure. In acute renal failure, peritoneal dialysis is performed in a hospital setting.

Persons undergoing dialysis treatment must comply with a special diet. Diet in dialysis consists in limiting the intake of liquid, table salt (at high blood pressure), limiting the intake of foods rich in potassium (fruits and vegetables) and phosphorus.

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