Prevention of Dialysis
Peritoneal dialysis is via an inserted tube, and sterile technique is necessary to prevent the introduction of infectious bacteria that could cause peritonitis. Infection is the most important and most frequent complication from peritoneal dialysis.
The catheter is the operational component to this type of dialysis, and catheter removal may be necessary when there is outflow failure, a leak, catheter cuff extrusion, abdominal wall hernia at the insertion site, or intestinal perforation. Hemodialysis may be necessary while awaiting replacement of a catheter or until any infection is cleared. Emergency surgery may be necessary to prevent loss of bowel or drain intra-abdominal abscesses.
Hemodialysis requires a surgically created access point for blood retrieval and return, either an implanted shunt or the establishment of an arteriovenous fistula.
Management and treatment of kidney disease using hemodialysis requires inspection and maintenance of the shunt, prevention of clots or infection, and assurance of patency. Anticoagulant therapy may be necessary if there is thrombus formation in the shunt or fistula. Removal of a shunt is indicated if it is colonized by bacteria.
Prevention of peritoneal dialysis-related complications, for the most part, requires strict sterile technique and periodic assessment of the catheter.
Prevention of kidney transplant failure requires immunosuppression and aggressive management of comorbidities that could threaten the implanted kidney, such as diabetes, dyslipidemia, and diabetes.