Physical Address
304 North Cardinal St.
Dorchester Center, MA 02124
Peritoneal Dialysis System
Objectives
This chapter will:
- 1.
Describe the anatomic characteristics of the peritoneal dialysis system.
- 2.
Discuss peritoneal microcirculation.
- 3.
Explain the mesothelial membrane.
- 4.
Discuss the dialysate compartment and the influence of different dialysate flow/dwell times on efficacy of treatment.
Several factors affect the delivery of therapy in peritoneal dialysis. They are the amount of fluid used, the frequency of exchanges, the dwell time, and the type of solution employed. However, the final efficacy of the therapy depends on the anatomic and functional components of the dialytic system, such as the peritoneal circulation (blood compartment), the mesothelium (peritoneal membrane), and the dialysate compartment. Once these components are described clearly, different parameters of each technique become the foundations for an adequate therapy prescription and a crucial factor in treatment delivery.
Peritoneal Dialysis System
Since the beginning of dialytic therapy, diffusion and convection have been combined in an attempt to replace renal function. The knowledge about diffusion came from industrial chemistry, and dialyzers were designed to be ideal countercurrent exchangers. Only later was convection used in clinical practice, showing potential advantages. Although ultrafiltration was employed first to treat overhydrated patients, convective was used subsequently to enhance solute removal. In peritoneal dialysis, such mechanisms of solute removal are employed with the same objectives as hemodialysis.
The peritoneal dialysis system has three major components: the peritoneal microcirculation, the peritoneal membrane, and the dialysate compartment, which includes the composition of the solution and the modalities of delivery. All of these components may have an important effect on the final performance of the technique ( Fig. 178.1 ).
You're Reading a Preview
Become a Clinical Tree membership for Full access and enjoy Unlimited articles
If you are a member. Log in here