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Video instructions and help with filling out and completing Cms guidelines for peritoneal dialysis
Music you complications of peritoneal dialysis by dr. Sharon sue introduction hello my name is dr. Sharon Suva pediatric nephrologist today I'm going to talk to you about peritoneal dialysis dialysis catheters one question that often comes up is when can you use a dialysis catheter this depends on the situation of the patient if it is a cube peritoneal dialysis the reason you put in the catheter is because you need to start dialysis immediately however if it's chronic as if it's planned for a patient that is reaching in stage renal disease or currently has a vascular of catheter for hemodialysis but we'll be transitioning to peritoneal dialysis then you have a little bit more time if you're going to use the catheter or you perform peritoneal dialysis immediately if they're very important to just start with very slow or small fill volumes that way you will reduce a chance of leakage ideally if you do have time to wait you want the site to heal well and seal off from leakage so if you put in a catheter and you can wait because you have other forms of renal replacement therapy such as hemodialysis then I would recommend waiting two to four weeks before starting peritoneal dialysis another thing to consider is that there are different types of catheters if in general for chronic peritoneal dialysis catheters that are cuffed as well as swan-neck which means they curl off at the end so that they reduce the risk of touching other organs in causing blockage those theoretically reduce the risk of infection they are used for patients who will be on chronic peritoneal dialysis cuffs catheters are also tunnel so they're tunneled through different layers of the skin from the epidermis to the sub-q layers and then into the abdominal cavity so those are made so that the risk of infection is less they have to be removed in the or because they are tunneled and cuffed so you can't just cut the stitches and pull it out simple straight catheters that are not cuffed or easily placed and also easily removed like but these have a higher chance of leakage if a patient has a Jeep tube that's been in place and well-heeled and sealed one can put in a pair to a valve Catherine there should be no problem or sometimes a g-tube is placed at the same time as a pair Gentiles catheter NAT case one should be pretty careful in how much fill volume you're going to fill into the peritoneal cavity complications with peritoneal dialysis peritonitis is a major complication of peritoneal dialysis 50 percent of the organisms come from Grande positive such as staph aureus staff epidermis streptococcus or Enterococcus 15 percent come from gram negative organisms such as Pseudomonas anaerobes or e-coli others have my polymicrobial so a component both pause grande positive and gram negative is accounts for four percent and less than two percent are caused by.