peritoneal dialysis

Download Peritoneal Dialysis

Post on 31-May-2015

405 views

Category:

Documents

0 download

Embed Size (px)

TRANSCRIPT

  • R E N A L R E S O U R C E C E N T R E

    An Introduction to

    Peritoneal Dialysis

  • An Introduction to

    Peritoneal Dialysis

  • PrefaceThis booklet has been written to provide prospective dialysis patients with some general information about kidney function and specific information about peritoneal dialysis . A companion booklet on haemodialysis is also available and it is recommended that you read both, especially if your renal physician has indicated that both treatments are medically suitable for you. Understanding why, when, where and how each form of dialysis is performed, will allow you to better consider which form of treatment will best suit you.

    Like many thousands of Australians before you, facing the prospect of dialysis treatment is daunting. No doubt you have many questions and many fears about what it will entail and how it will change your life. Most of all, you probably wonder if it will keep you well enough to enjoy a long, full and active life. Rest assured that both peritoneal and haemodialysis are very effective forms of dialysis and that there are currently over 10,000 Australians receiving dialysis treatment. Furthermore, there are over 7,000 Australians living with kidney transplants.

    After accepting the inevitable need for dialysis treatment, the next step is to decide which form of treatment will best suit you. There are two basic forms of dialysis - haemodialysis and peritoneal dialysis. Deciding which treatment is appropriate will depend on many factors. There may be medical reasons why your renal physician will recommend one over the other. In many cases, the choice will be entirely yours and will be influenced by several non-medical factors. The choice of treatment might be determined by your place of residence and the practicalities of attending for treatment. You may wish to consider your personal and family circumstances and how each form of dialysis will impact on those. It is always useful to consider how dialysis can be incorporated into your work, study, social life, leisure activities, business and holiday travel requirements.

    Australia boasts some of the best results in the world in caring for people with kidney failure and is a world leader in home haemodialysis. These successful outcomes are a result of not just access to the best medical care and leading edge technology but are also influenced by the partnership developed between you and your renal team. Hopefully, by reading this booklet and also attending educational sessions about your treatment options, you will be well placed to participate in that partnership and so successfully manage your treatment, whatever form it may take.

    In this booklet, we have attempted to anticipate your anxieties, fears, doubts and questions about peritoneal dialysis. However, a booklet cannot replace speaking with your physician and the staff of your renal unit. Knowing your individual circumstances, they are best positioned to guide you through the process of choosing the right treatment option.

    With the prospect of future treatment and lifestyle changes ahead, try to take things slowly and dont panic. What now seems overwhelming will soon be part of your routine. Read the information in this booklet carefully. We hope that it will help you to understand peritoneal dialysis and if and how it can benefit you. We wish you every success and good health.

    Denise OShaughnessy Senior Social Worker Renal Resource Centre March 2010

  • 2010

    RENAL RESOURCE CENTRE, 201037 Darling Point Road

    Darling Point NSW 2027Telephone: +61 2 9362 3995 or

    +61 2 9362 3121Freecall: 1800 257 189

    Facsimile: +61 2 9362 4354renalresource@nsccahs.health.nsw.gov.au

    www.renalresource.com

    An Introduction to Peritoneal Dialysis

    This publication has been supported by an educational grant from Amgen.

  • Contents

    Normal Kidney Function .................................................................................. 1

    Chronic Kidney Disease and Kidney Failure ....................................................... 2

    Dialysis ......................................................................................................... 4

    Haemodialysis ............................................................................................... 5

    Peritoneal Dialysis .......................................................................................... 5

    Peritoneal Dialysis Advantages ........................................................................ 7

    Peritoneal Dialysis Disadvantages .................................................................... 8

    Peritonitis ..................................................................................................... 9

    Methods of Peritoneal Dialysis....................................................................... 10

    Continuous Ambulatory Peritoneal Dialysis (CAPD) .......................................... 10

    The Exchange Procedure .............................................................................. 11

    Automated Peritoneal Dialysis (APD) .............................................................. 12

    Peritoneal Dialysis for Children ...................................................................... 12

    Peritoneal Dialysis & The Diabetic Patient ....................................................... 13

    Peritoneal Dialysis Education ......................................................................... 13

    Going Home ................................................................................................ 13

    Ongoing Care .............................................................................................. 14

    Diet ............................................................................................................ 14

    Medications ................................................................................................ 14

    Exercise ...................................................................................................... 16

    Relationships & Body Image .......................................................................... 16

    Pregnancy & Contraception ............................................................................17

    Holidays ...................................................................................................... 18

    Dialysis Supplies .......................................................................................... 18

    A Final Note ................................................................................................ 19

  • page 1

    Peritoneal Dialysis

    Normal Kidney FunctionThe kidneys are two of your vital organs and are located in the back of the abdominal cavity on either side of the spine, slightly above the small of the back. Each kidney is bean shaped, weighs approximately 150 grams and measures 11cm x 6cm (the size of a clenched fist).

    Each kidney is composed of millions of minute filters which remove waste products and excess fluid from the blood.

    The major function of the kidneys is to control the fluid and chemical balance of the body. In addition, the kidneys produce and regulate three main hormones:

    Erythropoietin: Stimulates the bone marrow to produce red blood cells. A decrease in red blood cell production may lead to the condition anaemia.

    Renin: Assists to control blood pressure.

    Active Vitamin D: Stimulates the absorption of calcium from the blood into the bones to keep them strong.

    The kidneys help maintain the chemical and fluid balance of the body. The kidneys are located in the back of the abdominal cavity, on either side of the backbone, slightly above the small of the back.

  • page 2

    Chronic Kidney Disease and Kidney FailureWhen the kidneys cease to function normally, resulting in a build up of waste products (toxins) and fluid in the body, the kidneys are said to be failing. Kidney or renal failure may be acute or chronic.

    Acute Kidney InjuryAcute kidney injury may occur following severe blood loss, serious kidney infection and various types of kidney disease. The kidneys suddenly cease to function but usually recover with treatment.

    Chronic Kidney DiseaseChronic renal failure means that kidney tissue has been destroyed gradually over a long period of time - usually months or years. Many people are unaware of the problem until more than 70% of kidney function has been lost. The aim of early detection of kidney disease and treatment (diet and medication) is to prevent or slow down progression of the disease. However, in some cases, the progression to end stage renal failure, when dialysis or transplantation is necessary, is not preventable.

    The most common causes of end stage renal failure in Australian today are diabetes mellitus, glomerulonephritis, hypertension and polycystic kidney disease.

    End Stage Kidney DiseaseEnd stage renal failure occurs when the kidneys can no longer function adequately and survival depends on either dialysis or transplantation. You have probably reached or are approaching this stage of kidney disease and your present treatment is aimed at easing the load on your damaged kidneys and minimising the accumulation of waste products in your body.

    Causes Of Chronic Kidney Disease Glomerulonephritis: Inflammation of the kidney. Diabetes Mellitus: Damage to the small blood vessels of the kidneys. Polycystic Kidney Disease: Kidney tissue destroyed by cysts. Reflux Nephropathy: Backward flow of urine causing kidney damage. Hypertension: High blood pressure. Gout: Exc