With the maturity of dialysis technology, uremia is no longer an insurmountable stubborn disease, and patients who receive dialysis treatment can not only continue to survive, but even have a good quality of life. Abbreviated as peritoneal dialysis, as one of the main means of renal replacement therapy, it uses the human peritoneum as a dialysis membrane to remove toxins and water from the body with hypertonic peritoneal dialysis fluid, thereby prolonging the life of the patient. Because of the relatively late start of abdominal dialysis technology in China, it is not yet recognized by the majority of medical personnel and patients, especially there are still some misconceptions about it, which hinders the application and development of abdominal dialysis in China.
Myth 1: Abdominal dialysis is not the first choice
Since the 1970s, hemodialysis has been the treatment that most uremic patients rely on for survival, and peritoneal dialysis is only considered when patients cannot undergo hemodialysis due to internal fistulae, active bleeding and other reasons. Therefore, many people mistakenly believe that peritoneal dialysis is a second option for patients. In fact, it is not. Except for a small percentage of patients who have contraindications to abdominal or hemodialysis, most patients can choose their own dialysis modality. Active participation in the choice of treatment modality is beneficial in building patients’ confidence and compliance to treatment, improving survival and quality of life.
It is now believed that although residual renal function is no longer sufficient to sustain the patient’s life, it still plays a large role in the control of water removal and nutritional maintenance, so how to protect residual renal function after dialysis has become a major issue in the field of nephrology. It has been well established that during the first 2 years of dialysis, abdominal dialysis is more beneficial for the protection of residual renal function, and the destruction of residual renal function is slowed by half. As a result, it is now recommended as the first choice for integrated renal therapy (i.e., hemodialysis, abdominal dialysis, and kidney transplantation) for patients with uremia.
Myth 2: Abdominal dialysis cannot be performed for a long time
Due to misconceptions about abdominal dialysis or the intervention of other non-medical factors, many abdominal dialysis patients choose abdominal dialysis only as a last resort due to the failure of hemodialysis, poor general condition, or even switch to hemodialysis after their condition improves. In fact, abdominal dialysis can also be carried out for a long time, and among 701 patients with long-term follow-up at the famous First Hospital of Sun Yat-sen Medical University in China, 56% had a technical survival of more than 5 years and 40% had more than 10 years. The average survival rate of abdominal dialysis patients in Japan has been reported to be 8 years. The longest surviving abdominal dialysis patient in Weifang has now been 13 years.
Myth 3: Abdominal dialysis affects life and learning
The initial stage of the development of abdominal dialysis in the last century, the relevant technology is still immature, requiring patients to clean the dialysis tubing with disinfectant solution, the operation process is more cumbersome, easy to contamination of peritonitis. However, the system currently used in China is a disposable double-bag system that does not require disinfectant solution and greatly simplifies the procedure, thus making it suitable for children and the elderly as well. Since peritoneal dialysis is performed at home, the simplification of the operating procedure has resulted in shorter operating times for patients, allowing many to perform household chores, take short trips, and even participate in work.
In particular, the use of automated abdominal dialysis machines frees patients from manual dialysis during the day and replaces it with machines that operate at night, which is closer to normal human life and more convenient for patients to return to work.
Myth 4: Abdominal dialysis can affect kidney transplantation
Some people believe that abdominal dialysis treatment and kidney transplantation are in the same abdominal cavity and that abdominal dialysis treatment will affect the choice of kidney transplantation in the future. Some studies have shown that abdominal dialysis prior to kidney transplantation has multiple benefits: the operation of abdominal dialysis is independent, the rate of hepatitis infection is low compared to hemodialysis, while the degree of anemia is light, avoiding the opportunity for hepatitis virus infection such as blood transfusion, and facilitating the use of anti-rejection drugs after kidney transplantation;
Peritoneal dialysis treatment itself or the protection of the residual kidney shortens the recovery time of the new kidney function after transplantation; the transplanted kidney is placed in the iliac fossa, outside the peritoneum, and does not affect the peritoneal dialysis performed, therefore, peritoneal dialysis treatment can be performed while waiting for the transplanted kidney to resume work or in the case of transplanted kidney failure. Doing peritoneal dialysis is just as good as doing a kidney transplant, and the success rate is even better than hemodialysis.
Myth 5: Abdominal dialysis can not be sexual life
Patients with advanced uremia, can appear a variety of symptoms, after effective alternative treatments such as hemodialysis, peritoneal dialysis and kidney transplantation, although many symptoms can be significantly reduced or even disappear, but sexual function and sexual life problems, but still long plagued patients. A considerable part of patients or spouses, fear and concern that sex will aggravate the disease and give up to have sex life.
This is a big misunderstanding! Kidney failure is not the same as sexual failure, chronic kidney failure patients and dialysis or kidney transplant patients, for sex, one should not have concerns, should try hard; two should not be excessive, should moderate the number of times, improve the quality; three is the spouse to support and tolerance. And the peritoneal dialysis person’s sex life should be relatively good.
Myth 6: Peritoneal dialysis can not bathe, life is inconvenient
Patients on peritoneal dialysis can bathe with protection in the first 2 weeks, and even without protection after 6 months.
Myth 7: Peritoneal dialysis is prone to peritoneal infection
With the improvement of peritoneal dialysis technology and products, the incidence of peritonitis has been very low. According to relevant medical literature, peritonitis occurs only once in 4 years on average for each peritoneal dialysis patient, and even once in 6 years or more in countries and regions with good economic and environmental health. And with the continuous development of drugs and medical technology, peritonitis is no longer a terrible infection.
Myth 8: Peritoneal dialysis is not as effective as hemodialysis
In fact, this is not true. The survival rate of peritoneal dialysis patients in the early stages (1-3 years) is higher than that of hemodialysis, and the 5-year survival rate is similar to that of hemodialysis.
Peritoneal dialysis patients also have a much better quality of life than hemodialysis.