Peritoneal dialysis application in acute and chronic end-stage kidney disease in the dog and cat

摘要

The technique of peritoneal dialysis in man has improved considerably in recent years. This is a result of the developments of a functionally reliable catheter, better control of peritonitis, and a new dialysis method, continuous ambulatory peritoneal dialysis (CAPD), whereby the peritoneum serves as a dialysis membrane 24 hours a day, 7 days a week. In clinical medicine, dialysis can be defined as the clearance of solutes from plasma into a dialysate solution across a semipermeable membrane. In hemodialysis processed cellulose capillaries serve as semipermeable membranes for hollow fiber kidney. Around the capillaries, rapid counter-current flow of dialysate interfaces with blood, establishing diffusion gradients for removal of uremic wastes. Inperitoneal dialysis, the patient's own peritoneum serves as a semipermeable exchange surface. Dialysate is designed to the abdominal cavity through a peritoneal catheter, allowed to remain for a prescribed period, and then removed. Dialysate is designedto be a physiological solution containing concentrations of dextrose for osmotic extracellular fluid removal. Dialysate does not contain urea, creatinine,or other nonprotein nitrogenous wastes, so these substances, through concentration gradients, clearfrom the plasma into dialysate.