Peritoneal Dialysis

End Stage Renal Disease

Causes and

Treatment Methods

Peritoneal Dialysis

The Kidney’s

Peritoneal Dialysis

The Kidney’s - Glomerulus

Peritoneal Dialysis

Dialysis Process

What Your Kidneys Do

Removes Metabolic Waste Fluid Balance Electrolyte Balance Acid Base Balance Hormone Production

Parathyroid Hormone Erythropoeiten Vitamin D Metabolism

Dialysis

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The Kidneys XXXXXXXXXX

Peritoneal Dialysis

Causes of Renal Failure

Diabetes Hypertension Glomerulonephritis Infectious Diseases Inherited Disease Drug Toxicity Other

Peritoneal Dialysis

Types of Renal Failure

Acute

Sudden Onset Short Duration Reversible Aggressive Dialysis or

Conservative Management

Chronic

Gradual Onset Not Reversible Prior to End Stage

Conservative Mgt. End Stage, Chronic

Management

Peritoneal Dialysis

Complications of Renal Failure

Hypertension Sodium Retention/Fluid Accumulation Anemia Dyspnoea Electrolyte Imbalance Acidosis Uraemic Syndrome

Peritoneal Dialysis

Uraemic Syndrome

Signs BUN and Creatinine Elevation

Symptoms GI Manifestations Neurological Manifestations Hematological Manifestations Dermal Manifestations Respiratory Manifestations

Loss of AppetiteNauseaChange in TasteFatigueSleep DisordersMental ChangesNeuropathyAnemiaItchingAcidosis Shortness of Breath

Peritoneal Dialysis

Recovery Acute Renal Chronic RenalFailure Failure

Renal End StageReplacement Renal Failure Therapy

Renal Replacement

Recovery Therapy

Death

Renal DiseasesPopulation

Risk Factors Mechanism of Injury

Renal Damage

Peritoneal Dialysis

Management of End Stage Renal Disease

Conservative Management Haemodialysis Peritoneal Dialysis

- CAPD, APD, NIPD, DAPD Transplantation No Treatment

Peritoneal Dialysis

Haemodialysis

Effective method to remove waste products

Performed by trained professionals

Disadvantages

Physical ups and downsPhysical ups and downs Use of needlesUse of needles Dietary restrictionsDietary restrictions Vascular accessVascular access Travel to CenterTravel to Center

Provides socialization for patients Only need dialysis 3 times per week. No equipment in the home (Unless Home HD)

Advantages

Peritoneal Dialysis

Peritoneal DialysisAdvantages

Manage your own care at home Greater independence and control Flexible treatment schedule Less restricted diet No needles Less stress on body Blood pressure control

Disadvantages Dialysis every day Permanent catheter Body image changes Risk of infection Possible weight gain Storage space needed for supplies.

Peritoneal Dialysis

TransplantationAdvantages

Most like your own kidney No dialysis needed No access needed Normal Diet (-sodium) More “normal” life style

Disadvantage

Risks of major surgery Risk of body rejecting kidney Possible side effects of drugs Lower resistance to illness Body image changes.

Patient's Kidney

Transplant Kidney(extra -peritonea lly)

Bladder

Peritoneal Dialysis

Withdrawal or No Treatment

Some patients may not be able to psychologically accept dialysis.

An elderly patient with co-morbid conditions may not be accepted for therapy.

Medical conditions may preclude therapy. Medical team, patient and patient family will

discuss treatment alternatives.