Policy Statements - PERITONEAL DIALYSIS
Passed by the NKF September 1997 (Amended 2008)
Each patient should be offered a dialysis regime to maximize his/her well-being, specifically:
Clearance rates are variable between patients. It is therefore essential to have a comprehensive system of monitoring dialysis adequacy for each individual.
Access: the key to successful dialysis is good and safe access to the peritoneal cavity.
There should be a national policy to ensure that catheter insertion is by experienced doctors, followed by a post-operative rest period of 7-10 days to reduce leakage.
Peritonitis: good patient education is essential to minimise the risk of infection.
Nutrition: the nutritional state of patients should be closely monitored.
Over 40% of PD users are undernourished (Young et al, 1991). Protein loss into dialysis fluid, anorexia, nausea and intra-abdominal pressure contribute to poor nutritional status. Decline is often gradual and difficult to correct when a high degree of malnutrition has been diagnosed.
Choice: patients should be offered a choice of PD systems: ie CAPD, APD, AAPD.