Peritoneal Dialysis 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: 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. 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.