Peritoneal dialysis is a technique whereby infusion of dialysis solution into the peritoneal cavity is followed by a variable dwell time and subsequent drainage. Continuous ambulatory peritoneal dialysis (CAPD) is a continuous treatment consisting of four to five 2-L dialysis exchanges per day (Fig. 4-1A). Diurnal exchanges last 4 to 6 hours, and the nocturnal exchange remains in the peritoneal...

Hypertension is very common in dialysis patients. The most important cause of hypertension is hypervolemia. Fluid restriction and volume management with standard hemodialysis are effective strategies to achieve dry weight and blood pressure control without use of antihypertensive drugs. If the captopril test is positive, a renin-angiotensin system blocker should be started. The pre-dialysis blo...

We have added insulin to peritoneal dialysis fluid in three uraemic diabetic patients. The hyperglycaemia and pronounced fluctuations in blood glucose which complicate peritoneal dialysis in diabetic subjects have not occurred with this technique. Studies with (131)I-labelled insulin showed that less than 5% of the intraperitoneally administered insulin was absorbed during a one-hour exchange. ...

used due to the blood pressure (BP) levels, we tried another depurative technique. The ECMO system haemofilter was used as dialysis membrane (1.4m poly-ethersulfone membrane; Cobe cardiovascular, Mirandola, Italy). Dialysis fluid was provided by two 5 l bags suspended above the patient (Figure 1). A ‘Y’ tube system was used to deliver a kalium-free dialysate (Na 140mmol/l, bicarbonate 34mmol/l)...