Selection for PD
Evaluation of the parent/caregiver Contraindications to chronic PD It is important to evaluate the family’s socio-economic and psychological background to determine the ability of the family to cope with the burden of care associated with the provision of chronic home treatment on a daily basis. In addition the level of education of the caregiver/parent is equally important. Evaluation of th
Evaluation of the parent/caregiver
Contraindications to chronic PD
It is important to evaluate the family’s socio-economic and psychological background to determine the ability of the family to cope with the burden of care associated with the provision of chronic home treatment on a daily basis. In addition the level of education of the caregiver/parent is equally important.
Evaluation of the parent/caregiver
Parents/caregivers and older patients should be informed about treatment options.
The parent or caregiver’s educational background and learning capacity should be evaluated in order to assess their ability to process the information necessary to do home PD successfully.
It may be necessary to individualise the training plan for the parent or caregiver.
In poor socio-economic circumstances, or in situations where the parents are illiterate or unwilling to co-operate with treatment, renal replacement therapy may not be in the best interest of the child.
Absolute indications for PD (in preference to HD) in children with end-stage renal failure:
- Very small child (<10 kg)
- Lack of vascular access
- Contraindication to anticoagulation
Performance of PD requires a patent abdominal cavity and a functioning peritoneal membrane across which solute and fluid transport can occur.
Contraindications to chronic PD
- Omphalocoele
- Gastrochisis
- Bladder extrophy
- Diaphragmatic hernia
- Obliterated peritoneal cavity
- Peritoneal membrane failure
Presence of a colostomy, gastrostomy, pyelostomy or ureterostomy does not preclude the use of chronic PD.
Van Biljon I, Bhimma R, Gajjar P, McCulloch M, Nourse P. Guideline for Chronic Dialysis in Children in South Africa. South African Renal Society; 2015.