How to choose peritoneal dialysate reasonably?

summary

My grandfather's uremia, now has peritoneal dialysis for a month, at home every day two bags of peritoneal dialysis fluid, 1.5 concentration. Appetite, sleep, spirit have been improved, but there is edema, especially in the afternoon after activities, face and feet will be swollen, better in the morning. The output of peritoneal dialysis fluid is less than the input. Edema in peritoneal dialysis patients is very easy to cause heart failure, which should not be underestimated. In general, there are two reasons for edema in peritoneal patients. The water from negative ultrafiltration peritoneal dialysis is less than that from perfusion. Malnutrition and edema in peritoneal dialysis patients should be controlled. Then I want to know how to avoid edema.

How to choose peritoneal dialysate reasonably?

1. Patients must know that the capacity state refers to the body fluid capacity, good capacity state lies in the balance of liquid in and out, edema is an important sign of volume overload. In peritoneal dialysis, volume overload is easy to cause edema. Record the daily urine volume and ultrafiltration volume, regularly check the capacity load related indicators, limit drinking water according to the urine volume.

2. Patients must understand that with the extension of peritoneal dialysis treatment time, the residual renal function of patients gradually decreases or loses. Even if the peritoneal function of patients does not change, the total water clearance will also decrease due to the decrease of residual renal function. This requires changing the dialysate concentration. Regular assessment of peritoneal function, according to the type of peritoneal transport, timely adjustment of dialysis prescription, maintain the appropriate amount of peritoneal ultrafiltration.

3. The elderly patients with peritoneal dialysis are more likely to be in the state of non dominant edema. Sometimes it is not accurate to judge the volume state only by clinical symptoms and signs, and need to rely on physical and chemical examination. Attention should be paid to the protection of residual renal function, avoiding the use of nephrotoxic drugs and dehydration. Avoid high salt food, can choose low sodium salt, cooking can add more seasoning, try to eat less water content, low nutritional value of food, such as vegetable soup, porridge, etc.

matters needing attention

Patients must go to large hospitals for regular treatment, do a comprehensive examination, must actively cooperate with the doctor's treatment, usually try not to eat spicy food, can eat more fresh fruits and vegetables, must regularly carry out some laboratory examination, to help determine the cause of edema, such as B-type natriuretic peptide, cardiac color Doppler ultrasound, bioelectrical impedance analysis, etc.