Recently, the Department of Nephrology of the First People's Hospital of Liangjiang New Area successfully performed peritoneal dialysis for a patient with chronic kidney disease stage 5 (uremia stage). The successful development of this technology marks that the hospital has entered the whole process of peritoneal dialysis management in the nephrology department, providing one-stop services for peritoneal dialysis patients.
The patient, Ou Mou, a female, 63 years old, was treated in the nephrology department due to edema, fatigue, vomiting and vomiting, and had a history of hypertension, proteinuria, and unilateral renal shrinkage. Immediately after admission, the examination was perfected, indicating that the serum creatinine was as high as 900 + umol /L, the hemoglobin was only 65 g/L, severe hypocalcemia and hyperphosphatemia, and the unilateral kidney was significantly reduced.
Combined with the patient's relevant manifestations, the diagnosis was stage 5 of chronic kidney disease (uremia stage), the patient was immediately placed with a temporary catheter, and blood purification treatment was started, and the patient's symptoms and related indicators were significantly improved.
The patient's disease diagnosis is clear, and long-term renal replacement therapy is required in the later stage, but the patient's home is far from the hospital, it is inconvenient to go to the hospital for hemodialysis treatment 3 times a week, and the patient's own vascular conditions are poor, if the cost of placing artificial blood vessels is high, if the risk of long-term catheter infection is relatively high, combined with the patient's situation, considering hemodialysis treatment is not the best choice for patients.
▲Placement of peritoneal dialysis tubes for patients with chronic renal failure
Under the leadership of Professor Zhang Jianguo, Director of the Department of Nephrology, and Deputy Chief Physician Jin Zhengrong, the general practitioner combined the patient's personal situation and communicated with the patient and his family to formulate a later long-term peritoneal dialysis treatment for the patient. At present, the patient has been placed with a peritoneal dialysis tube and peritoneal dialysis therapy has been initiated.
According to Zhang Jianguo, the peritoneal dialysis catheter is percutaneous puncture peritoneal dialysis catheterization, which has the advantages of less trauma, less postoperative pain, less postoperative complications, and faster postoperative recovery of patients than traditional open catheterization. (Photo: Zhang Yueqi)
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As we all know, hemodialysis is one of the renal replacement treatment methods for patients with acute and chronic renal failure, but in fact, peritoneal dialysis is applied to the clinic at the same time as hemodialysis, and has a history of more than 50 years. With the maturity of peritoneal dialysis technology, peritonitis is no longer a problem that plagues peritoneal dialysis, so abdominal dialysis has gradually become the best choice for early dialysis.
The so-called peritoneal dialysis is a dialysis method that uses the body's own peritoneum as a dialysis membrane. The exchange of solute and water between the dialysate infused into the abdominal cavity and the plasma components in the capillaries on the other side of the peritoneum removes the remaining metabolites and excess water in the body, while replenishing the substances necessary for the body through dialysate. By constantly renewing the abdominal dialysis fluid, the purpose of renal replacement or supportive treatment is achieved.
It is suitable for acute and chronic renal failure, high volume load, electrolyte or acid-base balance disorders, drug and poison poisoning and other diseases, as well as adjuvant treatment of liver failure, and can be administered transaberitoneally, supplemental nutrition, etc. It can also protect the residual kidney function, maintain the patient's urine output for 24 hours, effectively control anemia and hypertension, reduce cardiovascular and cerebrovascular complications, and is also the only choice for uremic patients who are not suitable for hemodialysis to maintain life.
Zhang Jianguo
Associate Professor, Director of the Department of Nephrology of the First People's Hospital of Liangjiang New Area, Deputy Director of the Department of Nephrology of the Former Army Characteristic Medical Center (Daping Hospital), engaged in the diagnosis and treatment of kidney diseases for more than 30 years, and a leader in medical academics. He is good at the diagnosis and treatment of common diseases and multiple diseases in nephrology, especially in the diagnosis and treatment of critical and difficult diseases in nephrology.