Chapter 137 Hemodialysis and Peritoneal Dialysis
• Hemodialysis (HD) and peritoneal dialysis (PD) are chiefly indicated to perform the excretory functions of the kidneys in patients with acute or chronic kidney failure.
• HD and PD can also be used to augment removal of certain toxins or toxicants and to remove excess water from the body in severe fluid overload.
• In HD the patient’s blood is pumped through an extracorporeal circuit. Interface between blood and dialysate (and resulting solute and fluid exchange) occurs outside the body across the many dialyzer membranes.
• PD uses the peritoneal membrane as an interface between the blood and dialysate; dialysate is instilled and removed through a catheter in the peritoneal cavity.
• Indications for dialysis include severe, intractable uremia (acute or chronic), severe hyperkalemia, intractable volume overload, and some acute toxicoses.
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