With the maturity of dialysis technology, uremia is no longer a persistent disease that cannot be overcome, and patients who receive dialysis treatment can not only continue to survive, but also have a better quality of life. As one of the means of renal replacement therapy (commonly known as dialysis), peritoneal dialysis uses the human peritoneum as a permeable membrane to remove toxins and water from the body with hypertonic peritoneal fluid, thereby prolonging the patient’s life.
Because of the relatively late start of abdominal dialysis technology in China, it is not yet known by the majority of medical personnel, especially patients, especially there are still some misconceptions about it, which hinders the application and development of abdominal dialysis in China.
Misconception 1: Abdominal dialysis is not the first choice
Since the 1970s, hemodialysis has been the treatment that most patients with uremia rely on for survival, and peritoneal dialysis is only considered when patients are unable to perform hemodialysis due to fistulas, severe anemia 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 conducive to building patients’ confidence and compliance with treatment and improving survival and quality of life.
It is now believed that although residual renal function is no longer sufficient to sustain patient life, it still plays a significant role in controlling patient water clearance 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 reported that during the first 2 years of dialysis, abdominal dialysis showed a more favorable protective effect on residual renal function, and thus is now recommended as the first choice for integrated renal therapy (i.e., hemodialysis, abdominal dialysis, and renal transplantation complement each other to jointly prolong patient survival) 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 failure of hemodialysis and poor systemic condition, or even switch to hemodialysis after their condition improves. In fact, abdominal dialysis can also be long-term, the famous Renji Hospital in China more than two hundred cases of long-term follow-up patients, more than seventy cases of survival more than three years, and some even more than ten years.
Myth 3: Abdominal dialysis affects life and learning
At the initial stage of the development of abdominal dialysis in the last century, the technology was not yet mature, requiring patients to clean the dialysis tubing with disinfectant, which is a tedious operation and prone to peritonitis due to contamination. 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 treatment before kidney transplantation has multiple benefits: the operation of abdominal dialysis is independent, and the rate of hepatitis infection is low compared with hemodialysis, while the degree of anemia is light, avoiding the opportunity of hepatitis virus infection such as blood transfusion, which is conducive to the use of anti-rejection drugs after kidney transplantation; abdominal dialysis treatment itself or the protection of the residual kidney makes the recovery time of the new kidney function after transplantation shorter; the transplanted kidney is placed outside the peritoneum (which does not affect the peritoneal dialysis performed ), so that peritoneal dialysis can be done either while waiting for the transplanted kidney to return to work or in case of transplant 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 have various conditions, and 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 still plague patients for a long time. 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 is 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, not only are peritoneal dialysis and hemodialysis equally effective, but the early survival rate of dialysis patients is even higher than that of hemodialysis, and the quality of life of peritoneal dialysis patients is far better than that of hemodialysis.