title: A Patient on Peritoneal Dialysis with Refractory Volume Overload.
abstract: The management of volume in patients with diabetes on peritoneal dialysis is affected by several factors, including the degree of residual renal function, peritoneal membrane small-solute transport, salt and water intake, blood sugar control, comorbidity, and nutritional status. It requires sequential evaluation of volume status and adjustment of the peritoneal dialysis prescription on the basis of assessments of membrane function and alterations in urine volume. Steps should be taken to preserve residual renal function for as long as possible. Ultimately, in patients who have become anuric and have developed ultrafiltration failure, timely transfer to hemodialysis may be necessary, requiring discussion and planning with the patient.
authors.affiliation: Sheffield Kidney Institute, Sheffield Teaching Hospital National Health Service Foundation Trust, Sheffield, United Kingdom; and Academic Unit of Nephrology, Department of Infection and Immunity, University of Sheffield, Sheffield, United Kingdom martin.wilkie@sth.nhs.uk.
authors.forename: Martin
authors.initials: M
authors.lastname: Wilkie
mesh_terms: D000368:Aged; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005936:Glucans / Q000494:pharmacology; D005947:Glucose / Q000494:pharmacology; D006801:Humans; D000077607:Icodextrin; D007668:Kidney / Q000503:physiopathology*; D010530:Peritoneal Dialysis / Q000379:methods*; D010537:Peritoneum
chemical_list: D005936:Glucans; D000077607:Icodextrin; D005947:Glucose
keywords: diabetic nephropathy; dialysis volume; icodextrin; peritoneal dialysis; peritoneal membrane