Peritoneal dialysis.

1. Peritoneal dialysis is a way to remove waste products from your blood when
your kidneys can no longer do the job adequately.
2. During peritoneal dialysis, blood vessels in your abdominal lining (peritoneum)
fill in for your kidneys, with the help of a fluid (dialysate) that flows into and
out of the peritoneal space.

3. Peritoneal dialysis differs from hemodialysis, a more commonly used bloodfiltering procedure.
4. Peritoneal dialysis isn't an option for everyone with kidney failure. You need
manual dexterity and the ability to care for yourself at home or a reliable
caregiver.
5. In peritoneal dialysis, a sterile cleansing solution (dialysate) flows through
the catheter into your abdomen.

6. The solution stays in your abdomen for a prescribed period of time, known
as dwell time.
7. During this dwell time, waste, chemicals and extra fluid in your blood pass
from tiny blood vessels (capillaries) in the lining of your abdominal cavity
(peritoneum) into the dialysis solution.
8. The solution contains a sugar that draws wastes and extra fluid through the
capillaries in your peritoneum into your abdomen.
9. Your belly may feel fuller than usual while the dialysis solution is there, but
it's generally not uncomfortable.
10.When the dwell time is over, the solution, along with waste products drawn
from your blood and any excess fluid, drains into a sterile collection bag.
11.The process of filling and then draining your abdomen is called an exchange.
12.Many factors affect how well peritoneal dialysis works in removing wastes
and extra fluid from your blood. These factors include:
a) Your size
b) How quickly your peritoneum filters waste (peritoneal transport rate)
c) How much dialysis solution you use (fill volume)
d) The number of daily exchanges
e) Length of dwell times
f) The concentration of sugar (dextrose) in the dialysis solution
13.Peritoneal equilibration test (PET). This test measures how much sugar has
been absorbed from a bag of used dialysis solution. It also measures how
much of two waste products , urea and creatinine , are in the solution after a
four-hour exchange.
Physiology of Peritoneal Dialysis.
1. Renal replacement therapy.

2. Involves transport of solutes and water across membrane that separates 2

fluid containing compartments a) peritoneal capillaries b) peritoneal cavities
3. In renal failure, blood in the peritoneal capillaries contains excess of urea,
creatinine
4. Dialysis solution in peritoneal cavities contain, Na, CI, HCO3 and high
concentration of glucose.
5. During peritoneal dialysis dwell 3 processes occur simultaneously; diffusion,
ultrafiltration and absorption.
6. Peritoneum lines the peritoneal cavity , peritoneal dialysis involve the
parietal peritoneum lines the walls of abdominal cavity.
7. Peritoneal membrane is lined by monolayer of mesothelial cells that has
microvilli that produces a thin lubricating films.
8. Peritoneum membrane is a type of mesothelium membrane
9. Under the peritoneum is the interstitium (gel-like matrix).
10. Peritoneal capillary is the critical barrier to peritoneal transport