Another patient with symptomatic uremia treated with intestinal dialysis: An educational article

Abstract

Background: Peritoneal dialysis actually acts by shifting the urinary excretion of urea to the peritoneal excretion with use of intraperitoneal dialysis fluids. Intestinal dialysis acts by shifting the urinary excretion of urea to intestinal excretion by modifying the enterhepatic urea cycle and increasing the amount of nitrogen eliminated as fecal waste. During intestinal dialysis, the patient consumes a relatively large amount of soluble fiber “acacia gum” which is digested by colonic flora, and cause a shift of urinary excretion. We have previously reported in several publications our pioneering and extensive experience with intestinal dialysis. Patients and methods: The case of 57 years old man with symptomatic uremia who refused hemodialysis treatment and treated with intestinal dialysis is described. Results: One week treatment with intestinal dialysis was associated with marked symptomatic and laboratory improvements. Blood urea was lowered from 162.4 mg/dL to 47 mg /dL, and serum creatine was lowered from 4.5 mg/dL to 1.1 mg /dL. Conclusion: Intestinal dialysis components include a urea lowering agent, powdered acacia gum, the dietary therapies of chronic renal failure, and the pharmacologic therapies of chronic renal failure which are also used during management with chronic hemodialysis and peritoneal dialysis. This paper reports another case showing that intestinal dialysis is effective in lowering blood urea level and improving symptoms in symptomatic chronic renal failure.