Recently, the Department of Nephrology of Shenzhen Hengsheng Hospital performed peritoneal dialysis catheterization for a patient with end-stage renal disease caused by diabetes, which solved the patient’s long-term pain and ignited hope for the patient’s life.
Old Kong (pseudonym) in his 50s is a “senior” diabetic patient, and his blood sugar management is “so-so”. 3 years ago, proteinuria and renal damage were discovered. After the Spring Festival, he came to Shenzhen Hengsheng Hospital because of chest tightness, shortness of breath, nausea and vomiting. Her serum creatinine was as high as 1400 umol/L (normal 44-73 μmol/L), carbon dioxide binding capacity was less than 6 mmol/L (normal 22-28 mmol/L), and she had severe hyperkalemia. The department immediately admitted her to the ward and underwent bedside CRRT treatment. The next day, Lao Kong’s symptoms improved significantly, but she kept frowning and worrying, often sighing and dazed by herself.
It turned out that 4 months ago, she heard that dialysis needs internal fistula surgery, but her vascular condition is too poor, the calcification of the radial artery and the ulnar artery wall is obvious, and the ulnar artery has plaques And the far end is narrow, which saddens their family. “I can’t dialysis, and I don’t think I can live for too long. I accept my fate!” Lao Kong said helplessly. Liu Xiaogang, deputy director of the Department of Nephrology, had a long talk with the patient and their family members. After a comprehensive evaluation of the patient’s family situation, hygiene habits, cognitive ability, autonomous operation ability, and mental state, it was recommended that the patient choose peritoneal dialysis treatment. The specific treatment plan is explained in detail. Head Nurse Xiong Jing led the nurses to synchronise and educate the patients and their families about peritoneal dialysis knowledge, alleviating their inner concerns.
On the morning of February 21, Deputy Director Liu Xiaogang personally performed peritoneal dialysis catheterization for the patient, and the operation went very smoothly. Under the careful treatment and nursing guidance of the medical staff, the patient’s wound healed well and the peritoneal dialysis went smoothly.
(Deputy Director Liu Xiaogang led the team to operate the patient)
Knowledge link:
The development of peritoneal dialysis technology, especially automated peritoneal dialysis technology, not only improves the therapeutic effect of peritoneal dialysis, but also makes home peritoneal dialysis easier to achieve; and the development of Internet-based telemedicine has further expanded the scope of application of home peritoneal dialysis .
What is peritoneal dialysis?
Simply put, the peritoneum is used as a dialysis membrane, and the peritoneal cavity is filled with dialysate by using its semi-permeable membrane properties. In addition, the peritoneal area is large and the capillaries are abundant. The blood in the peritoneal capillary lumen in the peritoneal capillaries exchanges substances with the dialysate, and removes metabolic wastes and excess water from the body through the principles of diffusion and osmosis.
Peritoneal dialysis is suitable for acute and chronic renal failure, high volume overload, electrolyte or acid-base balance disorders, drug and poison poisoning and other diseases. Preferred choice for infants and children with uremia.
Advantages of peritoneal dialysis
Peritoneal dialysis does not require the establishment of vascular access, which can avoid the pain and fear caused by repeated vascular puncture in children. Elderly people with cardiovascular complications have little impact on cardiovascular function; at the same time, they have a history of heart or cerebrovascular disease or unstable cardiovascular status, poor vascular condition or repeated arteriovenous fistula failure, coagulation dysfunction with obvious bleeding or bleeding tendency and Peritoneal dialysis can be given priority to those with good residual renal function.
In addition, peritoneal dialysis has fewer early complications than hemodialysis, and can better protect residual renal function; and it is simple to operate, does not require special equipment, and can be performed at home, with flexible dialysis time and high degree of freedom , there is no need to commute to the hospital 2-3 times a week, it has little impact on the patient’s work and life, and can better return to society. It is very suitable for office workers, remote and inconvenient uremia patients.
“The incidence of chronic kidney disease in my country is as high as 10.8%, and the number of people exceeds 100 million. On average, there is one chronic kidney disease patient in every 10 adults. The incidence of kidney disease remains high. The number of patients with end-stage renal disease is increasing year by year, and the choice of dialysis method has always plagued patients and families. According to the data of the National Blood Purification Registration System, by the end of 2021, there will be more than 800,000 patients receiving dialysis treatment in my country, including more than 100,000 peritoneal dialysis patients. The epidemic of new coronary pneumonia At present, home peritoneal dialysis treatment can avoid the risk of new coronary pneumonia transmission caused by uremic patients who need to be isolated to go to the hospital for hemodialysis. However, unfortunately, the current home peritoneal dialysis rate is less than 1%. Therefore, we have the responsibility and obligation to continue Continue to do a good job of propaganda and education to help them make more suitable choices.” said Liu Xiaogang, deputy director of the Department of Nephrology.
The Nephrology Department of Shenzhen Hengsheng Hospital will undergo major renovation and expansion, the scale of the hemodialysis center will be expanded to more than 70 units, and the specialized ward will be expanded to 50 beds. Center for Renal Pathology and Center for Clinical Translational Research in Renal Diseases. The Department of Nephrology of Shenzhen Hengsheng Hospital will establish a cooperative relationship with the Department of Nephrology of the famous double first-class universities in China, and strive to build the Department of Nephrology of Shenzhen Hengsheng Hospital into a more influential regional kidney disease research and diagnosis and treatment center within 5 years.