Passed by the NKF September 1997 (Amended 2008, Reviewed Nov 2019)

Each patient should be offered a dialysis regime to maximize his/her well-being, specifically:

Peritoneal dialysis should be offered for all patients on the basis of clinical need. All patients should have access, where clinically appropriate, to a choice of PD systems so that their lifestyle and preference can be accommodated. Standards and quality of care, with particular reference to adequacy of dialysis, should be maintained.

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Note

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.