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CKD-CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD)

Nephrology

CKD-CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD)

1. Close attention to nutritional status-a high-protein intake is necessary.

2. Fluid shifts are more gradual, so CAPD causes less strain on the heart.

3. The patient infuses 2-3 L of hypertonic dextrose solution into the peritoneal cavity (subsequently drained by gravity) 4-6/day. Many patients receive their PD exchanges at night using an automated cycler (called continuous cycler peritoneal dialysis, CCPD).

4. Main complication is peritonitis, usually caused by gram-positive skin flora (commonly S. epidermidis or S. aureus ), and gram-negative organisms.

5. Peritonitis should be suspected when the cell count of peritoneal fluid shows > 100 cells with > 50% PMNs.

6. Empiric intraperitoneal therapy with broad-spectrum abx should be initiated in suspected peritonitis pending C/S.

7. Other issues - high protein loss, hernias, hydrothorax, loss of water-soluble vitamins.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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