A clinical review of peritoneal dialysis.
OBJECTIVE
To review the principles and practice of peritoneal dialysis in veterinary medicine.


METHODS
Clinical and experimental studies and current guideline recommendations from the human literature; and original case studies, case reports, and previous reviews in the veterinary literature.


CONCLUSIONS
Peritoneal dialysis involves the exchange of solutes and fluid between the peritoneal capillary blood and the dialysis solution across the peritoneal membrane. It requires placement of a peritoneal dialysis catheter for repeated dialysate exchange. The ideal catheter provides reliable, rapid dialysate flow rates without leaks or infections. Catheter selection and placement are reviewed along with dialysate selection, exchange prescriptions, and overall patient management. PD does not require specific or complex equipment, and it can achieve effective control of uremia and electrolyte imbalances.


CONCLUSIONS
Peritoneal dialysis is a potential life-saving measure for patients with acute renal failure. Peritoneal dialysis results in gradual decline in uremic toxins. Previously low success rates have been reported. Improved success rates have been noted in dogs with acute kidney injury (AKI) secondary to leptospirosis. Cats also have a good success rate when PD is elected in patients with a potentially reversible underlying disease. Overall, PD remains a viable intervention for patients with AKI unresponsive to medical management. In select patients a favorable outcome is attained whereby PD provides temporary support until return of effective renal function is attained.
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1, Canada. bersenas@uoguelph.ca
Alexa M E
AM
Bersenas
D058186:Acute Kidney Injury / Q000628:therapy / Q000662:veterinary*; D000818:Animals; D002371:Cat Diseases / Q000517:prevention & control / Q000628:therapy*; D057785:Catheters / Q000662:veterinary; D002415:Cats; D004283:Dog Diseases / Q000517:prevention & control / Q000628:therapy*; D004285:Dogs; D006801:Humans; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods / Q000662:veterinary*; D010538:Peritonitis / Q000517:prevention & control / Q000662:veterinary; D011182:Postoperative Care / Q000379:methods / Q000662:veterinary; D017410:Practice Guidelines as Topic