Adult patient with HIV (since mid 80s) utilizing peritoneal dialysis daily instead of hemodialysis. Hemodialysis caused patient automatic deterioration in quality of life and produced extreme migraines. What are the long term effects on the membrane? Is it likely to withstand another 30-40 years of peritoneal dialysis?
Well, it is tricky. I doubt there is enough verified data to answer your questions, especially the second one. Theoretically, if nothing bad happens - and I mean sclerotizing for whatever reason (peritonitis, adhesions, bioincompatible solutions, etc.), the membrane should perform rather long-term, though the membrane characteristics may (and probably will) change over time. We have cases, started in early childhood and extending to advanced young age, so our experience is 10-12 years of properly functioning PD. The longest PD we handled was 15 years without major problems. Most of our patients gradually went from high-absorbers towards low-absorbers. For 30-40 years I am reluctant to speculate, sorry. Automated night-time PD with physiological pH and biocompatible solutions, wet day with long dwell (we add Heparin to it to prevent clotting) certainly help. I'd like to hear other experiences, too - from Mexico, perhaps?
As long as strict aseptic precautions are taken, the peritoneal selectivity may not alter even fo a long period of timer. However, if there is ensuing infection, the peritoneal function may alter due to sclerosis
- Badges
- Science topic
- Similar topics
- Medicine
- Disease
- Infectious Diseases