{"title":"处方和腹膜透析","authors":"Frank Reimann, Melinda Tomlins","doi":"10.18773/austprescr.2023.001","DOIUrl":null,"url":null,"abstract":"<p><p>Peritoneal dialysis is a home-based therapy for patients with end-stage kidney disease. It is less efficient in removing solutes and fluid than haemodialysis but offers more flexibility and independence. Peritoneal transport characteristics affect the dialysis prescription. The timing of drug administration is independent of the dialysis process except for the administration of intraperitoneal antibiotics. Dose reductions should follow current recommendations for patients with kidney disease. Fluid overload is common in patients undergoing peritoneal dialysis. Residual kidney function can ameliorate this problem and needs to be preserved. Dialysis solutions with high glucose concentrations contribute to adverse metabolic effects. Peritoneal dialysis-related catheter complications and infections may require patients to transition to haemodialysis. Antifungal prophylaxis needs to be co-administered for the duration of antibiotic courses for any indication to reduce the risk of fungal peritonitis. Close communication with the patient's supervising dialysis unit is required.</p>","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"1 1","pages":"5-8"},"PeriodicalIF":3.4000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10664089/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prescribing and peritoneal dialysis.\",\"authors\":\"Frank Reimann, Melinda Tomlins\",\"doi\":\"10.18773/austprescr.2023.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Peritoneal dialysis is a home-based therapy for patients with end-stage kidney disease. It is less efficient in removing solutes and fluid than haemodialysis but offers more flexibility and independence. Peritoneal transport characteristics affect the dialysis prescription. The timing of drug administration is independent of the dialysis process except for the administration of intraperitoneal antibiotics. Dose reductions should follow current recommendations for patients with kidney disease. Fluid overload is common in patients undergoing peritoneal dialysis. Residual kidney function can ameliorate this problem and needs to be preserved. Dialysis solutions with high glucose concentrations contribute to adverse metabolic effects. Peritoneal dialysis-related catheter complications and infections may require patients to transition to haemodialysis. Antifungal prophylaxis needs to be co-administered for the duration of antibiotic courses for any indication to reduce the risk of fungal peritonitis. Close communication with the patient's supervising dialysis unit is required.</p>\",\"PeriodicalId\":55588,\"journal\":{\"name\":\"Australian Prescriber\",\"volume\":\"1 1\",\"pages\":\"5-8\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2023-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10664089/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Australian Prescriber\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.18773/austprescr.2023.001\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australian Prescriber","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18773/austprescr.2023.001","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
Peritoneal dialysis is a home-based therapy for patients with end-stage kidney disease. It is less efficient in removing solutes and fluid than haemodialysis but offers more flexibility and independence. Peritoneal transport characteristics affect the dialysis prescription. The timing of drug administration is independent of the dialysis process except for the administration of intraperitoneal antibiotics. Dose reductions should follow current recommendations for patients with kidney disease. Fluid overload is common in patients undergoing peritoneal dialysis. Residual kidney function can ameliorate this problem and needs to be preserved. Dialysis solutions with high glucose concentrations contribute to adverse metabolic effects. Peritoneal dialysis-related catheter complications and infections may require patients to transition to haemodialysis. Antifungal prophylaxis needs to be co-administered for the duration of antibiotic courses for any indication to reduce the risk of fungal peritonitis. Close communication with the patient's supervising dialysis unit is required.
期刊介绍:
Australian Prescriber is Australia''s free, national, independent journal of drugs and therapeutics. It is published every two months online.
Our purpose is to help health professionals make informed choices when prescribing, including whether to prescribe a drug or not. To do this we provide independent, reliable and accessible information.
As well as publishing short didactic reviews, we facilitate debate about complex, controversial or uncertain therapeutic areas.
We are part of NPS MedicineWise, an independent, non-profit organisation providing medicines information and resources for health professionals, and stakeholders involved in the quality use of medicines. NPS MedicineWise is funded by the Australian Government Department of Health.