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Basic principles of peritoneal dialysis

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Background. In addition to hemodialysis and renal transplantation, peritoneal dialysis (PD) is an alternative renal replacement therapy that should receive more attention in Europe. Aim of the work. A vascular surgeon should be familiar with this method as an alternative to hemodialysis. Method. This article gives a review of the techniques available for peritoneal dialysis. Results. Peritoneal dialysis can be performed manually or automatically, continuously or intermittently, during the day or even at night using diffusion, convection and ultrafiltration to exchange renal toxins by administration of solutions containing different concentrations of dextrose. Catheter implantation includes open, laparoscopic or a combination of both techniques, besides the interventional guided placement with their respective advantages and disadvantages. Different catheters ranging from the classical Tenckhoff (R) model to self-locating models with tungsten are available. Catheter dislocation and infections are the main complications of peritoneal dialysis. Conclusions. The mortality and morbidity associated with peritoneal dialysis is similar to that of hemodialysis. The patients benefit from this method as the continuous dialysis offers more comfort and a greater freedom of movement.

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