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peritoneal dialysis

Mycobacterial PD peritonitis

One of the most feared complications of peritoneal dialysis is that of PD peritonitis. Infection with gram positive (50-70%) organisms accounts for the vast majority of cases. The typical presentation is with abdominal pain, fever and cloudy dialysate…

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More insulin!

Peritoneal dialysis solutions containing glucose polymers are becoming more popular, particularly in patients on APD who tend to retain fluid during their daytime fills. The rationale for their use is that they lead to a reduced absorption of…

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PD: Catheter outflow failure

I recently saw a patient in our peritoneal dialysis clinic who had been ultrafiltering about a liter a day but who was now consistently draining 100ml less than his instilled PD solution volumes despite extended drain times and…

Board question of the week: PD-1

A 55-year-old woman with ESRD secondary to lupus nephritis presents to the PD clinic with volume overload. She reports decreased UF volume, despite the use of 4.25% dextrose exchanges over the last few weeks. She has been on…

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ACE inhibitors and PD

Back to the subject of ACE inhibitors again. There are a number of reasons why ACEi might be particularly beneficial for patients on PD and two recent editorials in KI and CJASN laid these out very well. 1….

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PD University for fellows

I attended a 2-day conference on home dialysis known as “PD University for fellows” sponsored by the International Society for PD (ISPD), Wake Forest University, Baxter and NxStage in Baltimore, MD. This is a free conference for renal…

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PD vs HD in the elderly

Patients over 65 tend not to choose peritoneal dialysis for a host of reasons, not the least of which is PD is underutilized in the US in general. However, a recent study suggests that PD may be preferable…

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