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Drajad priyono
Modalities of renal replacement therapy
Non-infectious:
• Leakage of dialysate along the peritoneal catheter
• Drainage failure of dialysate (dislocation or catheter
obstruction by fibrin)
• Morphologic changes of peritoneum following long-
lasting PD (peritoneal fibrisis, mesotelial damage,
vasculopathy and neo-angiogenesis) leading to loss of UF
capacity – reason for PD cessation in 24% of all patients,
and in 51% of patients treated above 6 years.
Causes of UF failure
Nutrineal2
• No glucose exposure
• No GDPs or AGEs
• Membrane and immune cell
function
Nutrineal
Glucose load
Glycemic control
Protein intake, nutritional status
2.5 L 2.5 L
2 Physioneal 2.5 L Physioneal 2.5 L
1.36% Nutrineal 1.36% Extraneal
Thank you
Peritoneal dialysis - outline
• Principles of PD
• PD solutions
• PD catheter
• Indication / contraindication of PD
• PD schemes : CAPD, CCPD
• Assessement of PD adequacy,
ultrafiltration
• Assessement of peritoneal function
• Complications
• Perspectives – new dialysis solutions
Ideal)PD)access
! Minimal)trauma)/)pain
! Rapid)fluid)infusion)without)pain
! Allow)complete)drain
!
Maintain)stable)position)without)extrusion)of)
deep)and)superficial)cuffs
! Allow)PD)therapy)for)many)years)
2
Saturday, March 30, 13