Wearing Out My Peritoneum

[Restorer]

I keep hearing that using high-dextrose PD fluid regularly will wear out your peritoneum more quickly. How quickly are we talking about? I'm betting it varies per person, like everything else, but what's the order of magnitude? If I were to start using 4.25% solution every night from now on, would it last me a couple months? A year? A couple years? I know that even without using high concentration solution, some people wear out within a couple years, and some people go on for many years with no problem.

I've lost some peritoneal function since I started, but I think that's mainly due to a couple bouts of peritonitis I've had. I haven't used pure 4.25% solution since I started on the cycler - the most I use is one 4.25% bag and one 2.5% bag.

[Rerun]

I'm not sure.  Just enjoy it while you can.  It is what it is, and I'm not sure you can stop it.

[KICKSTART]

I have just gone through this ! True the strength will wear it out quicker , but there is no set length of time, everyone is different. I used a mixture of 1.36, 2.25 and 3.36 bags and i did nearly 5 years . I think its like saying if 2 people fell over one might break an arm , one might not , but you dont know which one it would be . Everyones body is different , so you cannot put a time on PD

[peleroja]

I was beginning to think the same thing when they told me my last Adequest was 1.5 (they want at least 1., so I repeated it and lo and behold it came in at 2.38, so I guess I'm doing ok for now.  I mostly use all green, but occasionally my ankles swell up for several days and I put a red on the cycler.  I used to be in a Yahoo group and one man there had been on PD for 17 years.

[looneytunes]

This topic is a great concern of mine also.  Hubby's adequacy test was not good last time and his neph has mentioned a couple of times that he may need to go back on hemo.  He is now the only "high volume" patient our clinic has on PD.  He does 11,500 ml per day and is "hooked up" 10 to 11 hours a day.  We have another kt/v test set up for this Monday so we are hoping it will be better.  He dreads going back on hemo as he was so sick when he was on it before.  Home hemo is not an option in our rural area right now as there are no supporting clinics.  So...we just hope and pray his peritoneum will last a long time. 

[koutsounel]

the surgeons have told us that 5 years is best case scenario - this can be reduced by peritonitis or surgery. In order to protect the peritoneum, we have now started extraneal, this helps as our son uf's on initial drain and his bp is under control.

[KICKSTART]

They cant put a time on it ! One of the pd patients i came across had been on pd for 14 years !!!!

[BETTY55111]

I am in fluid overload right now. My Neph. told me today to use the 4.25% in both bags every night. I had been using one 4.25 and one 2.5. I am very swollen and distended. I was worried about using the 4.25.

[Restorer]

When it needs to be done, it needs to be done. It's better to risk using high concentration solutions than risk continued fluid overload.

[looneytunes]

Betty 5511:  I agree with Restorer.  The higher solution strength is scary but the consequences of fluid overload is even more scary.  Follow the advice of your neph. 

[M3Riddler]

Be advised that you can not only wear out your peritoneaum, but you can also develop a rare, painful, high mortality condition called Encapsulating Peritoneal Sclerosis.
This condition is due long term dialysis. Peritonitits can also set this condition off along with Higher Dextrose Use over long term.
I was on PD for 13 years and I developed EPS. It is a dreadful condition that you do not want. Most Nephrologists do not even know much about the condition although within recent years, it is becoming more known.
EPS is a condition where your peritoneal cavity becomes incased in fibrous tissues and it wraps around the bowel and other organs. It causes small bowel bstructions among other complications. It has a very high mortality rate unles it is caught early. I had to switch to Hemo and will never be able to do PD again because of this.
Many Nephroogist will not even bring this condition since it is so rare, but they are seing more cases as people are living longer on PD.
Just Google Encapsulating Peritoneal Sclerosing for more info.
Anyone that wants more info feel free to email me at m3riddler@nxstageuers.com

///M3R

[jennyc]

Hi, I wasn't aware of that. Does that include the extraneal - 7.5% maltodextrin solution or does it only apply to the glucose solutions? I've been using the extraneal during the day so that i don't gain weight and i only use 1.5% solution during the evening on cycler (still passing urine). I don't get much fibrin(? spelling) in my bags and my lining is now failing but i've had a good run so i guess i can't complain and i'm enjoying fluid now before my urine output goes kaput on heamo.