I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: KICKSTART on November 18, 2010, 03:06:18 PM
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Is there any written documentation that states the peritoneum if left for x amount of time does not heal? Has anyone had to come off pd and then tried to return to pd but only after being told its stopped working? I often wonder if once switched to hemo , its just to easy to leave you on it ? I know a lot of body parts can regenerate or heal themselves , but ive never heard of any research in returning to pd.
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The damages to the peritoneum is reversible (in rat studies).
http://www.pdiconnect.com/cgi/reprint/19/Suppl_2/S384.pdf
In conclusion, peritoneal rest improves ultrafiltration in
rats by reducing the hyperpermeability of glucose. In
addition, peritoneal rest reduced the degree of peritoneal
membrane thickening, suggesting that the structural changes
caused by peritoneal dialysis and simulated peritonitis are
reversible. Further investigation is needed to examine the
The peritoneal membrane undergoes significant changes
in structure during long-term continuous ambulatory peritoneal dialysis (CAPD). These changes
involve both the mesothelial and intersti tial portions of the peritoneal membrane (1) and affect the transperitoneal
solute exchange. Over time on CAPD, some patients develop a hyperpermeability of the peritoneal membrane to
small solutes. This situation leads to a more rapid dissipation of the glucose osmotic gradient and a relative
loss of ultrafiltration (2). Ultrafiltration loss is one of the major causes of withdrawal from long-term peritoneal
dialysis (3). Peritoneal rest by using temporary hemodialysis for a month has been reported to be of benefit for type I
ultrafiltration failure: that is, for patients whose poor fluid removal is due to excess absorption of the glucose (4).
However, the relationship between changes in peritoneal permeability and peritoneal morphology during peritoneal
rest has not been previously reported. Therefore, the aim of the present study was to evaluate the effects of peritoneal
rest on peritoneal transport and morphology using a rat model of peritoneal dialysis.
However, in human studies, only a small percentage can return to PD after temporary HD.
edited: the URL was incorrectly duplicated in the original post, the following is the correct reference
http://jasn.asnjournals.org/content/13/4/1040.abstract
It was concluded that after an episode of severe peritonitis that required Tenckhoff catheter removal, only a small group of patients could return to peritoneal dialysis.
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After having a pretty nasty fungal peritoneal infection, I was told to forget PD and stick to HD. I wasn't happy, because I didn't want to be on HD at all, let alone have to be on it permanently. I actually cried in the recovery room when they told me that they weren't able to place a new PD catheter.
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My only input on this topic is what I found out recently,
that the Peritoneal lining hardens in time
and lasts about 12-15 years maximum,
but I can’t find out if the Peritoneal lining regenerates
and softens again allowing PD to be recommenced.
So I too wonder if it is possible to come back from HD to PD.
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Thank you greg10 for your research. So we would be better off if we were rats? hmm :rofl;
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Yeah Sluff thats what i thought , although from time to time i feel like a lab rat ! Interesting info guys ..thanks.