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Despite its many benefits, peritoneal dialysis (PD) uptake is quite poor in many countries. For example, in Malaysia, around 12% of all patients with end stage kidney disease (ESKD) are on PD). One barrier to use of this…
“Let’s Talk About Peritoneal Dialysis” Post 8: EPS, A Feared Complication of PD
Encapsulating Peritoneal Sclerosis (EPS) is an extremely rare, but devastating possible complication of peritoneal dialysis. The International Society of Peritoneal Dialysis (ISPD) defines it as a “syndrome continuously, intermittently, or repeatedly presenting with symptoms of intestinal obstruction caused…
“Let’s Talk About Peritoneal Dialysis” Post 7: My Effluent Looks Like Milk
Hey doc, my effluent looks kinda like milk…would it taste good with cookies? Chyloperitoneum is a rare cause of cloudy or even outright white milky effluent. This classic appearance is due to the presence of chylomicrons in a…
“Let’s Talk About Peritoneal Dialysis” Post 6: We Have a Leak!
In the differential diagnosis of inadequate ultrafiltreation, one of the possible entities is a dialysate leak. The more insidious leak will present with weight gain and decreased drain volumes as the dialysate leaks into different planes/potential spaces and…
“Let’s Talk about Peritoneal Dialysis” Post 5: Why Won’t My Patient Ultrafiltrate?
Is my peritoneal dialysis (PD) patient’s hypervolemia due to ultrafiltration failure (UF)? UF is a specific diagnosis with a definition of a failure to achieve 400 mL of ultrafiltration during a 4 hour dwell using 4.25% dextrose. While…
“Let’s Talk About Peritoneal Dialysis” Post 4: Not Drain Pain…But Infusion Pain
Welcome to post 4 of the “Let’s Talk About Peritoneal Dialysis (PD)” Series! In post 3 we discussed drain pain, and today we discuss infusion pain (pain during dialysate infusion into the abdomen) which can be just as distressing…
“Let’s Talk About Peritoneal Dialysis” Post 3: Drain Pain…Ouch
“Hey doc, it hurts every time I do this.” “Well, stop doing that.” Ah, if it were so simple. What is one to do when “this” is draining peritoneal dialysis (PD) dialysate? A simple question with a not…
“Let’s Talk About Peritoneal Dialysis” Post 2: When There’s No Flow…
A common call the nephrologist will receive when managing a peritoneal dialysis (PD) patient is that of poor flow. This problem is classically described as “one way” or “two way.” One Way Obstruction: Classically defined as as slow…
“Let’s Talk About Peritoneal Dialysis” Post 1: The Peritoneal Equilibration Test (PET)
Welcome to a series of posts titled “Let’s Talk About Peritoneal Dialysis.” Today, we will be discussing the Peritoneal Equilibration Test (PET) that is performed in peritoneal diaysis (PD) patients. I distinctly recall my first time as a…