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Related Concept Videos

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
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DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
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Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
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A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
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Peritoneal dialysis and cardiovascular disease.

O Balafa1, R T Krediet

  • 1Department of Nephrology, University Hospital of Ioannina, Ioannina, Greece. olgabalafa@gmail.com

Minerva Urologica E Nefrologica = the Italian Journal of Urology and Nephrology
|September 14, 2012
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Summary

Cardiovascular death is the leading cause of mortality in peritoneal dialysis (PD) patients. Overhydration, driven by loss of residual renal function and ultrafiltration failure, is the primary PD-specific risk factor for cardiovascular disease.

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Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • Cardiovascular (CV) death is the most frequent cause of mortality in peritoneal dialysis (PD) patients.
  • Risk factors for CV death in PD patients encompass general population risks, end-stage renal disease (ESRD)-specific factors, and PD modality-specific issues.

Purpose of the Study:

  • To identify and delineate the spectrum of cardiovascular risk factors in patients undergoing peritoneal dialysis.
  • To differentiate between general, ESRD-related, and PD-specific contributors to cardiovascular mortality.

Main Methods:

  • Review and synthesis of existing literature on cardiovascular risk factors in PD patients.
  • Analysis of the contribution of various factors including hypertension, obesity, inflammation, malnutrition, calcifications, endothelial dysfunction, oxidative stress, glucose load, and overhydration.

Main Results:

  • Hypertension is a major general risk factor in PD patients; obesity's role is debated.
  • ESRD-specific factors like inflammation, malnutrition, calcifications, endothelial dysfunction, and oxidative stress contribute significantly to CV mortality.
  • PD-specific factors include glucose load (leading to insulin resistance and atherogenic lipid profile) and overhydration (due to loss of residual renal function and ultrafiltration failure), with overhydration being the most critical.

Conclusions:

  • Cardiovascular disease in PD patients is multifactorial, influenced by general, ESRD-related, and PD-specific risk factors.
  • Overhydration emerges as the most significant PD-related risk factor for cardiovascular mortality.
  • Management strategies should address these diverse risk factors to improve outcomes in PD patients.