1. Peritoneal Dialysis End Stage Renal Disease Causes and Treatment Methods

2. Peritoneal Dialysis The Kidney’s

3. Peritoneal Dialysis The Kidney’s - Glomerulus

4. Peritoneal Dialysis Dialysis Process What Your Kidneys Do  Removes Metabolic Waste  Fluid Balance  Electrolyte Balance  Acid Base Balance  Hormone Production  Parathyroid Hormone  Erythropoeiten  Vitamin D Metabolism Dialysis XX XXX XXXX X XXX XX The Kidneys XXXXXXXXXX

5. Peritoneal Dialysis Causes of Renal Failure  Diabetes  Hypertension  Glomerulonephritis  Infectious Diseases  Inherited Disease  Drug Toxicity  Other

6. Peritoneal Dialysis Types of Renal Failure Acute  Sudden Onset  Short Duration  Reversible  Aggressive Dialysis or Conservative Management Chronic  Gradual Onset  Not Reversible  Prior to End Stage Conservative Mgt.  End Stage, Chronic Management

7. Peritoneal Dialysis Complications of Renal Failure  Hypertension  Sodium Retention/Fluid Accumulation  Anemia  Dyspnoea  Electrolyte Imbalance  Acidosis  Uraemic Syndrome

8. Peritoneal Dialysis Uraemic Syndrome Signs  BUN and Creatinine Elevation Symptoms  GI Manifestations  Neurological Manifestations  Hematological Manifestations  Dermal Manifestations  Respiratory Manifestations Loss of Appetite Nausea Change in Taste Fatigue Sleep Disorders Mental Changes Neuropathy Anemia Itching Acidosis Shortness of Breath

9. Peritoneal Dialysis RecoveryAcute Renal Chronic Renal Failure Renal End Stage Replacement Renal Failure Therapy Renal Replacement Recovery Therapy Death Renal Diseases Population Risk FactorsMechanism of Injury Renal Damage

10. Peritoneal Dialysis Management of End Stage Renal Disease  Conservative Management  Haemodialysis  Peritoneal Dialysis - CAPD, APD, NIPD, DAPD  Transplantation  No Treatment

11. Peritoneal Dialysis Haemodialysis  Effective method to remove waste products  Performed by trained professionals Disadvantages  Physical ups and downs  Use of needles  Dietary restrictions  Vascular access  Travel to Center  Provides socialization for patients  Only need dialysis 3 times per week.  No equipment in the home (Unless Home HD) Advantages

12. Peritoneal Dialysis Advantages  Manage your own care at home  Greater independence and control  Flexible treatment schedule  Less restricted diet  No needles  Less stress on body  Blood pressure control Disadvantages  Dialysis every day  Permanent catheter  Body image changes  Risk of infection  Possible weight gain  Storage space needed for supplies.

13. Peritoneal Dialysis Transplantation Advantages  Most like your own kidney  No dialysis needed  No access needed  Normal Diet (-sodium)  More “normal” life style Disadvantage  Risks of major surgery  Risk of body rejecting kidney  Possible side effects of drugs  Lower resistance to illness  Body image changes. Patient's Kidney Transplant Kidney (extra-peritoneally) Bladder

14. Peritoneal Dialysis Withdrawal or No Treatment  Some patients may not be able to psychologically accept dialysis.  An elderly patient with co-morbid conditions may not be accepted for therapy.  Medical conditions may preclude therapy.  Medical team, patient and patient family will discuss treatment alternatives.