Name of the Procedure:

Dialysate Solution, Non-Dextrose Containing, 500 ml
Common Name: Peritoneal Dialysis Solution
Technical/Medical Term: A4728 Dialysate Solution

Summary

Peritoneal dialysis is a treatment for kidney failure that uses the lining of your abdomen, or belly, to filter waste from your blood. Special fluid called dialysate is used in this process. Instead of sugar (dextrose), this particular dialysate solution contains other osmotic agents to help rid your body of waste products, extra water, and salts.

Purpose

This dialysate solution is used in peritoneal dialysis to help remove waste products and excess fluids from the body. It is particularly useful for patients who may not tolerate dextrose well.

Indications

• Chronic kidney disease or end-stage renal disease.
• Situations where dextrose-containing solutions are not advisable.
• Patients requiring peritoneal dialysis who have improved outcomes or fewer side effects from non-dextrose solutions.

Preparation

• No specific fasting required.
• Patients should discuss medication adjustments with their healthcare provider.
• Ensure thorough handwashing and cleanliness to prevent infections.
• Check that all necessary supplies are sterile and readily available.

Procedure Description

1. Setup: Clean the area and gather supplies including the dialysate solution, transfer set, and catheter.
2. Connection: Connect the dialysate bag to the catheter and drain the used fluid from the abdominal cavity.
3. Infusion: The new dialysate solution is then infused into the peritoneal cavity.
4. Dwell Time: The solution remains in the cavity for a prescribed period allowing waste products and extra fluid to diffuse.
5. Drainage: After the dwell period, the solution, now containing waste, is drained out.

Tools Used:

• Dialysis catheter.
• Sterile dialysate solution bag.
• Transfer set.

Anesthesia or Sedation: Not usually required.

Duration

The procedure, including setup and drainage, typically takes about 30-60 minutes, not including the dwell time, which can range from 4 to 8 hours, depending on prescriber instructions.

Setting

Typically performed at home, but can also be done in a hospital or outpatient clinic.

Personnel

• Primary: Patient or a trained caregiver.
• Supportive: Nephrologist, nurse educator, patient training staff.

Risks and Complications

• Infection (peritonitis).
• Catheter-related issues.
• Abdominal pain or discomfort.
• Dialysate leakage.
• Rare: Electrolyte imbalances.

Benefits

• Removes waste products and excess fluid from the body.
• Can be done at home, allowing for greater convenience.
• Flexibility with schedule.
• Non-dextrose solution often causes fewer metabolic complications.

Recovery

• Post-procedure care includes monitoring for signs of infection.
• Patients can generally resume normal activities shortly after each cycle.
• Regular follow-ups with healthcare provider.
• Maintenance of a sterile environment to prevent infections.

Alternatives

• Hemodialysis: Uses a machine to filter blood outside the body, usually performed in a clinic.
  • Pros: Shorter treatment times, less frequent sessions.
  • Cons: Requires vascular access, more restrictive diet and fluid limits.
• Dextrose-Containing Peritoneal Dialysate: An alternative dialysate containing sugar.
  • Pros: Widely available, effective.
  • Cons: Potential for metabolic complications like weight gain and blood sugar spikes.

Patient Experience

• During the procedure, you may feel some pressure or fullness in the abdomen.
• Most patients find the procedure relatively painless.
• Pain management usually not necessary, but mild discomfort can be alleviated with positioning or mild analgesics.
• Post-procedure, you may feel relieved from the buildup of fluid and toxins.