Complete Dialysate Drainage: An Unnecessary Step in Intermittent Peritoneal Dialysis

Abstract

Peritoneal dialysis was performed in 16 renal-failure patients to study the necessity of complete drainage during the outflow period. Comparison between complete drainage (CD) and the accelerated inflow and limited outflow (AILO) showed no difference of drainage volume despite the accelerated outflow during the AILO period. It is postulated that the higher level of dialysate in the fluid line during the AILO period resulted in a relative increase availability of the outflow through the catheter perforations. In the CD period the peritoneal clearances of urea, creatinine and inulin were lower because of inefficient transport of these solutes during the outflow phase. The authors concluded that complete drainage is not necessary in intermittent peritoneal dialysis. During intermittent peritoneal dialysis, dialysate drainage volume usually is a major concern among medical and nursing staffs. Particularly during the initial exchange, dialysate frequently is retained because of a pocket of fluid in an inaccessible area of the peritoneal cavity (1). Thus, in subsequent exchanges considerable effort is made to stimulate drainage so as to avoid further accumulation. This prolongs outflow time and takes up the time and attention of paramedical personnel. The present study was done to evaluate the necessity of complete dialysate drainage in term of mechanics and efficiency of dialysis.