PERITONEAL DIALYSIS

Peritoneal dialysis (PD) is a method of renal replacement with proven efficacy, offering a useful alternative to hemodialysis and renal transplantation in the treatment of end-stage chronic renal failure. It is an extra-renal purification technique based on the principle of exchange, through a semi-permeable peritoneal membrane, of solutes according to a concentration gradient, and of solvent according to a depression gradient. The two therapeutic modalities are continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD), with their variants. Functional explorations of the peritoneum and criteria for adequate dialysis make it possible to adapt the treatment modality according to residual renal function, the degree of permeability of the peritoneal membrane and to verify the quality of treatment in order to reduce morbidity. Complications are dominated by peritoneal infections, catheter malfunction and loss of ultrafiltration, which may necessitate transfer to hemodialysis.