Low Volume Exchange Protocol for Peritoneal Dialysis After Abdominal Surgery

Authors: Plevšičnik, Z; Lavre, J; Vujkovac, B; Pečolar, S

Source: Therapeutic Apheresis and Dialysis, Volume 9, Number 1, February 2005 , pp. 78-78(1)

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Abstract:

Abdominal surgery is considered problematic if performed on dialysis patients who are on peritoneal dialysis. There is a common clinical practice to switch these patients to hemodialysis postoperatively for a period of time. Our attempt was to keep these patients on peritoneal dialysis after abdominal surgery, using a modified protocol of low volume exchanges. During the last two years, three of our patients on peritoneal dialysis underwent abdominal surgery. In one patient, laparoscopic cholecystectomy was performed, and abdominal hernia repair was performed in the other two. The day after the operation, we started with low volume (500 mL) exchanges with solutions with 1.36% glucose. During the daytime we prescribed four exchanges, and during the nighttime we put patients on automatic peritoneal dialysis (APD), also with low volume exchanges. After 5 days, the volume of exchanges was gradually increased and after 3 weeks all three patients were on their standard preoperative dialysis regime. Periodically, we controlled the adequacy of dialysis with Kt/V, which was not changed during these procedures. There were no complications postoperatively. We conclude that this modified protocol of peritoneal dialysis was useful and safe in all our patients and there was no need to switch patients to hemodialysis. Further clinical experience with a large number of patients might confirm the usefulness of low volume exchange protocol.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1526-0968.2005.222_1_1.x

Affiliations: 1: Department of Dialysis, General Hospital Slovenj Gradec, Slovenia

Publication date: 2005-02-01