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The initiation of peritoneal dialysis: planning the initial prescription
1Clinical Professor of Medicine, Yale University, Hospital of St. Raphael, New Haven, Conn., USA.
Abstract:
The initiation of peritoneal dialysis (PD) requires that the nephrologist address certain key issues. These include patient selection for PD, the timing of the placement of the PD catheter, the timing of the initiation of PD, the schedule of PD to be utilized, and the initial regimen of PD to be prescribed. In addressing these issues, the nephrologist needs to consider not only the medical condition of the patient but also the psychosocial status and quality of life concerns of the patient and his/her family. Furthermore, the dialysis treatment regimen needs to be organized to maintain the long term viability of PD therapy.
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Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...

