Peritoneal dialysis prescription in children: bedside principles for optimal practice View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2009-09

AUTHORS

Michel Fischbach, Bradley A. Warady

ABSTRACT

There is no unique optimal peritoneal dialysis prescription for all children, although the goals of ultrafiltration and blood purification are universal. In turn, a better understanding of the physiology of the peritoneal membrane, as a dynamic dialysis membrane with an exchange surface area recruitment capacity and unique permeability characteristics, results in the transition from an empirical prescription process based on clinical experience alone to the potential for a personalized prescription with individually adapted fill volumes and dwell times. In all cases, the prescribed exchange fill volume should be scaled for body surface area (ml/m(2)), and volume enhancement should be conducted based on clinical tolerance and intraperitoneal pressure measurements (IPP; cmH(2)O). The exchange dwell times should be determined individually and adapted to the needs of the patient, with particular attention to phosphate clearance and ultrafiltration capacity. The evolution of residual kidney function and the availability of new, more physiologic, peritoneal dialysis fluids (PDFs) also influence the prescription process. An understanding of all of these principles is integral to the provision of clinically optimal PD. More... »

PAGES

1633-1642

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00467-008-0979-7

DOI

http://dx.doi.org/10.1007/s00467-008-0979-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1049185854

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/18807074


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