Techniques in Peritoneal Dialysis

Understanding peritoneal physiology and technical innovations in peritoneal dialysis has led to a significant reduction in therapy-related complications over the last four decades. Technology and techniques to perform peritoneal dialysis (PD) have evolved and, in its current form, are reliable, easy to use, and come at an acceptable cost. Also, various regimens and modes of PD allow for social interaction and optimizing PD efficiency in terms of solute clearance and fluid removal. Overall, the successful advances in PD techniques have prompted broader utilization and served as the foundation for major ESKD healthcare reform initiatives in the USA to support further growth of home-based dialysis [1]. We will outline procedural principles and details of variations of flow techniques (tidal, intermittent, or continuous), regimens [intermittent PD (IPD or continuous PD (CPD)], and modes of PD (manual or automated). These strategies allow for using tidal PD (TPD), continuous flow peritoneal dialysis (CFPD), assisted peritoneal dialysis, urgent-start PD, incremental PD, and remote patient monitoring (RPM) in clinical practice [2]. We will also outline various approaches that can further enhance the scope of PD usage in specific clinical situations.