Contraindications to peritoneal dialysis

Due to the simple technology of peritoneal dialysis, there are fewer contraindications to peritoneal dialysis. About 20% of the patients in the clinic are limited to peritoneal dialysis, in which case hemodialysis is a more appropriate choice. The structural and functional integrity of the peritoneum is a prerequisite for the success of peritoneal dialysis, and patients with the following conditions are absolute contraindications to peritoneal dialysis, as follows: 1. Various abdominal lesions lead to abnormalities in the structure and function of the peritoneum, and if the peritoneal surface area is reduced or the flow of peritoneal dialysis fluid is not smooth, it can affect the removal of uremic toxins and water, and cannot achieve adequate dialysis, such as recent abdominal surgery, abdominal cavity, tumor extensive peritoneal metastases, peritoneal cavity and peritoneal cavity, and so on. Tumor extensive peritoneal metastasis, serious infection of the abdominal cavity, etc.; 2. Extensive skin infection of the abdominal wall or severe burns can not be intubated. There are other relative contraindications to peritoneal dialysis, this part of the patient is not absolutely can not do, but do peritoneal dialysis treatment effect may be less satisfactory. Relative contraindications are as follows: 1, abdominal surgery within 3 days, if the wound has not healed, peritoneal dialysis incision will have leakage; 2, late pregnancy or a huge mass in the abdominal cavity. Due to the reduced volume of the abdominal cavity, the effect of abdominal dialysis will be unsatisfactory; 3, a high degree of intestinal obstruction is prone to poor drainage of abdominal dialysis fluid. In addition, patients with unrepaired abdominal hernia, peritoneal dialysis fluid is prone to increase intra-abdominal pressure and aggravate the abdominal hernia; 4. Severe respiratory insufficiency. When the patient’s peritoneal dialysis fluid intake is too large, it will elevate the diaphragm, compress the lung tissue, and aggravate respiratory insufficiency. If peritoneal dialysis must be done, the amount of peritoneal dialysis infusion must be reduced at this time; 5. In patients with a cleft in the septum, the dialysis fluid can enter the thoracic cavity through the cleft in the septum, leading to a large amount of pleural effusion and respiratory dysfunction.