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Negative effects of Fluid removal - Coggle Diagram
Negative effects of Fluid removal
Protein loss problems
via peritoneal membrane
Increase oral supplements
Increase amino acid dialysate
Eat 1.0 - 1.2 g/kg of body weight/day of dietary protein
Cardiovascular/lipid problems:
ventricular hypertrophy, coronary ischaemia, vascular disease
High cholesterol and triglycerides
Not long lasting; peak levels ~ 3-12 months
Raised intraabdominal pressure problems:
Caused by the pressure of high volume of fluid in peritoneal cavity; exacerbated by strenous activities or excessive coughing
Increased risk of abdominal hernias
: inguinal, incisional, diaphragmatic, umbilical
Surgical repair
Alternative tx - HD if indicated
Dialysate leakage
around catheter site
Edema of labia, penis, scrotum
Stop PD for a short time (1 week)
Surgical repair/maybe PD while lying down
Alternative tx - HD if indicated
Risk of infection
STOP PD immediately
Drainage problems
Kinks in tubing
Patient should be taught to check for kinks and closed clamps
Malpositioned during surgery
Surgical intervention
Constipation
Problems with dialysis outflow/risk of infection
High fibre intake
Laxatives or glycerin suppositories
Avoid phosphate-containing enema (can be reabsorbed)
Regular exercise
Fibrin formation
Blocks catheter or tubing
Milking the tube
Heparin to dialysate solution as prophylaxis
Streptokinase and urokinase in NS should be infused into catheter, clamps and left for 2h
Malpositioned catheter
Caused by obstruction of omentum attached to the catheter tip
Remove omemtum or remove catheter completely and reinsert
Shoulder pain
Referred from intraabdominal pressure or air under diaphragm
Mild analgesia e.g. paracetamol 1g
Blood-stained effluent
Caused by: menstruating, endometriosis/retrograde bleeding through fallopian tube
Rectify within 1-2 days without intervention