Dialysis Team Research Articles

Psychiatric disturbance in chronic renal failure and its treatment by dialysis

Summary The psychiatric disturbance in patients with chronic renal failure is described and some of the aetiological factors reviewed. A number of psychiatric problems arise during the course of treatment by haemodialysis, both among patients, relations and members of dialysis teams. Their course, treatment and prognosis are discussed.

INCREASING EFFICIENCY OF PERITONEAL DIALYSIS

Intermittent peritoneal dialysis is a safe procedure which does not demand the continuous presence of a highly trained dialysis team(1, 2). However, as usually performed, it is relatively inefficient, and therefore requires a prolonged dialysis time and large volumes of sterile solution to achieve the desired result. Previous attempts have been made to improve efficiency by increasing dialysate exchange rate(2) and by continuously flowing fresh dialysis solution through the peritoneal cavity(3,4). With both methods, clearance was enhanced by increasing flow rate up to 60 ml. /min. At higher dialysate flows, clearance diminished. Recirculation peritoneal dialysis is anew method to increase efficiency of peritoneal dialysis without using large volumes of sterile dialysate. With this technique a reservoir of sterile intraperitoneal fluid is continuously recirculated through an extracorporeal dialyzer and back into the peritoneal cavity at a rapid flow rate. Recirculation peritoneal dialysis is safe and easy to perform. Furthermore, clearance rates obtained in the present study were far in excess of those achieved with other methods of peritoneal dialysis.