Complications of peritoneal dialysis

The early complications of peritoneal dialysis: (1) intubation complications visible wound bleeding, a small amount of bloody fluid in the abdominal cavity, visceral perforation, mild intestinal obstruction after intubation, dialysis fluid leakage, the tunnel inside the dialysis tube distortion, poor drainage dialysis fluid dialysis tube obstruction and displacement and so on. (2), peritonitis is the most common complications, including bacterial, fungal, tuberculosis, chemical and eosinophil cells increased peritonitis, and recurrent infections peritoneal thickening, adhesions, dialysis efficiency decreased, eventually leading toCAPD failure. (3) excessive abdominal pain, peritonitis, abdominal swelling, stimulation of hypertonic glucose dialysate pH, improper preparation or concentration is too low and improper location of dialysis tube can cause abdominal pain. (4) suited to peritoneal dialysis or decreased bowel initially can produce bloating bloating. (5) vagal reflex symptoms in some patients in the input or discharged dialysate bradycardia, hypotension and dyspnea vagal reflex symptoms. (6) The electrolyte and acid-base balance disorder due to dialysis is inadequate, does not control or poor diet, can cause hyperkalemia or hypokalemia. (7), hypotension, dry weight underestimated, or use inappropriate high glucose, hypertonic dialysate, a lot of dehydration may cause hypovolemia, hypotension. (8), pulmonary insufficiency irrigation fluid increased intra-abdominal pressure affect pulmonary function, diaphragm elevation. (9) Other, such as low back pain, adhesions, hemorrhoids aggravated and so on. Peritoneal dialysis long-term complications are: (1) loss of the syndrome in CAPD patients a day lost by the peritoneal dialysis fluid protein of about 5 ~~ 10g, individual differences in ~~ 20g / d; daily loss of free amino acids 2 ~ 4g, 80% of essential amino acids; loss of water-soluble vitamin B1, C, B6, folic acid, as well as enteric vitamin D Therefore, long-term peritoneal dialysis can lead to malnutrition, hypoalbuminemia, neuropathy, immunocompromised and susceptible to infection. (2) peritoneal dialysis loss of ultrafiltration peritoneal dialysis patients with ultrafiltration volume <400ml / d, are ultrafiltration failure, peritoneal dysfunction. To peritoneal mesothelial cells are damaged mainly the so-called type 1 ultrafiltration failure, expressed as intra-abdominal dialysate glucose absorption rate and fast, causing the permeability quickly lost, but the increase in the permeability of urea, dialysate urea, creatinine, D / P values. Another due to multiple adhesions of the peritoneum and / or hardening caused by the irreversible change in type 2 ultrafiltration failure, should extubation change hemodialysis. (3) increase of glucose load, abnormal lipid metabolism in CAPD patients daily can absorb glucose in the dialysate volume of 70% (100 to 200g / d), long-term peritoneal dialysis can cause obesity, can cause blood triglyceride rise increase in insulin secretion, leading to abnormal lipid metabolism. (4) cardiovascular complications in end stage renal failure patients often have heart damage, high cycle capacity in the process of dialysis treatment, dialysis is inadequate and anemia, can make existing heart disease increase. (5) metabolic bone disease. Vitamin D in patients with metabolic abnormalities in the blood calcium and phosphorus balance disorders, leading to secondary hyperparathyroidism, plus iatrogenic photo aluminum increased, resulting in dialysis osteodystrophy and metastatic calcification, and gradually increased. (6) any time the pulmonary complications of peritoneal dialysis patients with pleural effusion, and even can be a sudden increase to the right side is more common. (7) abdominal hernia in CAPD patients about 20% of the concurrent abdominal hernia, inguinal hernia, incisional hernia. Cataract in peritoneal dialysis patients (8) differences in solute concentration within the crystal in the blood too much, coupled with an increase in glucose concentration in the blood, and micronutrient deficiencies, so that the crystal protein glycosylation, the crystal to produce large amounts of sorbitol, promote fibrosis, caused by cataract . (9) can also cause hearing loss, carpal tunnel syndrome, acquired renal cysts and renal cancer and other complications.