peritoneal dialysis
| Site: | EHC | Egyptian Health Council |
| Course: | Nursing Procedures Guidelines for Hemodialysis |
| Book: | peritoneal dialysis |
| Printed by: | Guest user |
| Date: | Tuesday, 5 May 2026, 11:38 PM |
Description
"last update: 12 March 2025"
- Prepared by
Under supervision
- Prof. Dr. Mohamed Latif, CEO of the Egyptian Health Council
Dr. Kawthar Mahmoud, Head of the Egyptian Nursing Syndicate - Member of the Senate
Prepared by
|
Title |
Name |
NO. |
|
Dean Of Faculty Nursing, Professor of Medical and Surgical Nursing, Tanta University |
Dr Afaf Abdel Aziz Abdel Aziz Basal |
1 |
|
Professor Of Critical Care Nursing |
Prof.Dr/Zeinab Hussain Ali |
2 |
|
Professor And Head of the Department of Medical Surgical Nursing. Faculty-. Benha University |
Amal Said Taha Refaie |
3 |
|
Supervisor Of the Education Sector at Port Said University |
Amal Ahmed Khalil Morsy |
4 |
|
Professor Of Medical Surgical Nursing- Faculty of Nursing- Cairo University |
Dr. Hanan Ahmed Al Sebaee |
5 |
|
Head of central administration on secondment at MOHP |
Dr Neveen ab drab al0nabi Mohamed |
6 |
|
Director Of Primary Health Care Nursing Department at MOHP. |
Maysa Hosny Ahmed Tammam |
7 |
|
Supervisor Of Technical Education- EHA |
Nancy Alaa Eldeen Abd-Elbaset Ali |
8 |
|
Supervisor Of Nursing Services Development- EHA |
Sherien Mohamed Saad |
9 |
|
Assistant Professor of Maternity and Neonatal Health Nursing - Faculty of Nursing- Ain Shams University |
Assist.Perof. Dr./Heba Mahmoud Mohammed |
10 |
|
General manager of general administration of health institutes affairs |
Dr Mai Galal Ibrahim Al-Assal |
11 |
|
Participants |
||
|
member of the Nursing administration at EHA, port said branch |
Mr. Ahmed Zarq Al-Sayed |
12 |
|
member of the Nursing administration at EHA, ismailia branch |
Mrs. Radwa Al-Sayd Al-Nagdi
|
13 |
|
member of the Nursing administration at EHA, ismailia branch |
Mrs. Omnia Hassan Absi |
14 |
- Peritoneal dialysis
Peritoneal dialysis aims to remove waste from the blood when the kidneys are unable to perform their function properly. During peritoneal dialysis, the cleansing fluid flows through a catheter (tube) into a part of the abdomen. The peritoneal membrane (peritoneum) in the abdomen acts as a filter, removing waste from the blood. After a specified period, the fluid with the filtered waste flows out of the abdomen and is disposed of. The patient can perform peritoneal dialysis at home, at work, or even while traveling.
types:
➡️Continuous Ambulatory Peritoneal Dialysis:
- The purification fluid is changed manually between three and four times a day. Each change takes approximately 30 to 40 minutes, and it remains in the abdominal area for a period ranging from four to six hours.
➡️Automated peritoneal dialysis:
The purification fluid is changed using a device that is installed during sleep.
Duration of peritoneal dialysis:
Its duration varies depending on the type of peritoneal dialysis.
The cases in which peritoneal dialysis is recommended:
1. When the patient wishes to avoid needle pricks and handling blood.
2. When there is no desire to disrupt daily activities.
3. When wanting to work or travel more easily.
4. When the kidneys perform some of their functions.
1. Contraindications for peritoneal dialysis:
1. The presence of extensive surgical scars on the abdomen.
2. The patient underwent several surgeries in the abdominal area.
3. Weakness of the abdominal muscles.
4. Inflammation of the intestines, or recurrent episodes of intestinal obstruction.
5. Malnutrition and protein deficiency.
6. If the patient is suffering from morbid obesity.
- Components of the peritoneal dialysis machine
· Catheter: A tube that the surgeon inserts into the abdominal cavity before starting peritoneal dialysis sessions (of all types), and it remains permanently attached to the body.
- Dialysis fluid: A liquid composed of water and certain substances prescribed by the doctor according to the condition, such as dextrose and others. It is packaged in containers ranging from one and a half liters to three liters and should be warmed before use.
- Peritoneal dialysis machine: It is only available with automated peritoneal dialysis, and it is a device that fills and empties the purification fluid while sleeping.
➡️Before performing peritoneal dialysis:
The surgeon is inserting a catheter from the outer abdominal wall to the inside. The catheter takes a period of 10 to 20 days to heal completely, after which the patient can start the dialysis process.
.
- How peritoneal dialysis works
n of the purification liquid: The patient pumps the cleansing fluid through the catheter into the abdominal area, then disconnects the catheter from the cleansing fluid bag to be able to resume normal activities. Meanwhile, the body is rid of waste and excess water, which transfer to the cleansing fluid through the peritoneal membrane for several hours.
Purification liquid discharge: After the period ends, the patient connects the catheter to drain the fluid, including waste, from the body through it.
➡️Side effects:
Infection:
1. Infection is the most common symptom of peritoneal dialysis. Infection occurs when the catheter is contaminated, or the area around it is contaminated. Symptoms of infection include: abdominal pain, fever, nausea and vomiting, redness and pain around the catheter, discoloration of the dialysis fluid after it is removed from the body, and discharge from the catheter.
2. Weight gain:
3. This is due to the purification liquid containing dextrose sugar.
4. Hernia:
5. Storing fluids in the abdomen for long periods may cause a hernia due to the strain on the abdominal muscles.
6. Insufficient peritoneal dialysis:
7. Peritoneal dialysis may become ineffective after several years, and it may be necessary to switch to hemodialysis.
- Diagnosis of the effectiveness of peritoneal dialysis
Measuring weight.
1. Measuring weight.
2. Blood pressure measurement.
3. Laboratory tests:
4. To determine the effectiveness of peritoneal dialysis, especially in the first week, the amount of used purification fluid is collected after it has been drained from the body over 24 hours, and a blood sample is taken during this period to measure the amount of waste present in both. A urine sample may also be taken if there is a sufficient quantity, and its concentration is measured.
5. Other tests, such as kidney function tests, glomerular filtration rate, albumin test, hemoglobin test, transferrin test, parathyroid hormone tests, and potassium, phosphorus, and calcium level tests.
In the case of peritoneal dialysis inefficiency:
The caregiver may make the following changes:
1. Increasing the number of peritoneal dialysis sessions per day.
2. Increase the amount of purification liquid.
3. Increasing the concentration of the purification liquid.
Disadvantages of the Bertoni washing method:
1- Possibility of skin infection/inflammation or blood poisoning
2- A clot in the cannula, but it can be removed with heparin.
3- Seeking rain
4- Weight gain
5- Abdominal muscle strain
6- The ineffectiveness of peritoneal dialysis after several years
- The role of nursing staff towards patients undergoing peritoneal dialysis
1- Monitor vital signs and intake/output, and inform the doctor if there is a
fluid accumulation in the patient's abdomen exceeding 300 cm.
2- Change the cannula site at least once a day.
2- Keep the spare parts dry and clean.
General guidelines:
1.
Talk to a nutritionist about the weight gain caused by dextrose sugar, and
whether the patient has diabetes.
2. Maintaining the integrity of the catheter, by:
3. Ensuring its safety every day.
4. Avoid wearing clothes or belts around the catheter exit.
5. Keeping her away from sharp tools.
6. Cleaning it daily with water and soap.
7. Do not tamper with it, and avoid pulling it or trying to insert it.
Is
there any harm in skipping or forgetting one of the peritoneal dialysis
sessions?
Yes; as the repetition of forgetfulness leads to the accumulation of toxins in
the body, in addition to causing changes in the peritoneum.
Misconceptions:
Power outages during automated peritoneal dialysis disrupt the washing process.
The truth: Not true.
- References
◾ Clinical practice guidelines for peritoneal dialysis adequacy. Am J Kidney Dis. 2019;48 Suppl 1:S98-129
◾ Figueiredo A, Goh BL, Jenkins S, Johnson DW, Mactier R, Ramalakshmi S, et al. Clinical practice guidelines for peritoneal access. Perit Dial Int. 2020;30(4):424-9.
◾ Crabtree JH, Shrestha BM, Chow KM, Figueiredo AE, Povlsen JV, Wilkie M, et al. Creating and Maintaining Optimal Peritoneal Dialysis Access in the Adult Patient: 2019 Update. Perit Dial Int. 2019.
◾ Aguiar PV, Santos O, Teixeira L, Silva F, Azevedo P, Vidinha J, et al. Overhydration prevalence in peritoneal dialysis - A 2 year longitudinal analysis. Nefrologia. 2021;35(2):189-96.