Peritoneal dialysis can be done in most patients. There are a number of conditions that may make hemodialysis the preferred dialysis approach.
Contraindication - inadequate peritoneal cavity resulting in inadequate dialysis:
(1) history of colostomy
(2) history of ileostomy
(3) polycystic kidney disease
Contraindication - peritoneal cavity not intact:
(1) recent abdominal surgery with drains or draining wounds
(2) diaphragmatic hernia (pediatric)
(3) omphalocele (pediatric)
(4) gastroschisis (pediatric)
(5) defect in the diaphragm, such as post-traumatic rupture
Contraindication - risk of complications:
(1) history of abdominal aneurysm surgery
(2) severe obstructive lung disease
(3) severe peripheral vascular disease
(4) diverticulosis of the bowel
Contraindication to perform the procedure at home:
(1) unable to perform the procedure properly (failure to understand or adhere to procedure)
• The following conditions were not listed as contraindications but which strike me as posing problems: active Crohn's disease, diffuse peritonitis with adhesions, diffuse carcinomatosis, hepatorenal syndrome, necrotizing enterocolitis (pediatric).
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Specialty: Nephrology, Clinical Laboratory