Peritoneal Dialysis

Im on peritoneal dialysis, but I am swelling a lot. Could you tell me how to eliminate it? Here we give you four suggestions. Hope they can help you.

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How to Eliminate Swelling for Peritoneal Dialysis Patients

2019-03-18 16:38

Question: I’m on peritoneal dialysis, but I am swelling a lot. Could you tell me how to eliminate it?

How to Eliminate Swelling for Peritoneal Dialysis PatientsAnswer: Peritoneal dialysis is an effective renal replacement therapy. In the course of treatment, edema of lower limbs and even the whole body often troubles patients. In most cases, edema is a manifestation of excessive capacity load in the body, which is often said to be more "water" in the body. So what if the capacity load is too heavy? Here are some suggestions for you:

(1) Restriction of water and sodium intake

Water intake is mainly aimed at maintaining the target body weight, estimated by urine volume plus peritoneal dialysis ultrafiltration plus non-dominant loss of water. In addition, excessive sodium intake increases the volume load of patients, so salt intake should be controlled. Therefore, the restriction of drinking water and sodium intake should be strengthened to improve compliance.

(2) Diuretic

Large dose of loop diuretics (furosemide 250-1000mg/d) has no effect on the recovery of renal function, but can significantly increase urine volume. At present, there are no reports of toxic and side effects of oral large dose loop diuretics, but attention should be paid to adverse reactions such as ototoxicity.

(3) High permeability liquid

The use of dialysates containing higher glucose (2.5% and 4.25% peritoneal dialysates) increase the fluid osmotic pressure in the abdominal cavity and the ultrafiltration volume. It should be noted that high osmotic pressure dialysate can damage the peritoneum, so it should be used in combination with the clinical situation, and try to avoid long-term use.

(4) Change the time of abdominal retention and the times of exchange

Increasing the number of dialysate exchanges increases the amount of ultrafiltration more than the decrease of the time of retention of dialysate. And increasing the duration of retention of dialysate at the same dialysate dose helps to remove excess sodium in the body. Therefore, according to the specific situation of sodium or water removal and the results of peritoneal balance test, we should decide whether to increase the duration of abdominal retention or the number of exchanges.

Finally, we remind you that if the problem of excessive capacity load occurs, it is still necessary to consult a doctor in time, because the doctor's advice is more reliable. If you would like to get our renal expert’s guidance, please leave a message below or send emails to kidney-symptoms@hotmail.com.

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