Tidal peritoneal dialysis in a patient with cystic fibrosis

During the brief time P.H. was treated with PD, the following outcome criteria were achieved: The patient maintained his desired weight, nutritional status, hematocrit, and fluid volume status within established parameters. He was independent in his care and demonstrated appropriate and safe problem-solving techniques. Although the nephrology staff had expected behavioral problems typical of a chronically ill child, we quickly learned that preconceived ideas are not always the case. Individualizing a dialysis regimen that provided adequate solute clearance and sufficient ultrafiltration for this patient with multiple health problems was a case management challenge for the entire nursing staff. Unfortunately his extrarenal medical problems affected a change in his chosen dialysis modality. With his volume and membrane limitations, it was doubtful he could have continued on PD for a prolonged period once his residual renal function diminished. We were optimistic that he would return to our program following this hospitalization, but the decision was taken out of our hands.