| [ Summary ] |
It took about 60 years to develop peritoneal dialysis (PD) as an established therapy for chronically uremic patients. Because we needed to develop three major devices; effective dialysis fluids to improve uremic conditions without adverse effects, practical peritoneal access for instillation/drainage of the solution, and a safe closed system to prevent peritonitis. With the evolution of CAPD by Popovich and colleagues in 1976, PD became a safe enough technique to be performed for long periods. However, we still need to have more biocompatible PD materials; dialysis solutions, peritoneal catheters, etc. In considering long-term PD, we are now facing the more fundamental problems of PD. How long we can use the peritoneum as dialysis membrane? What are the criteria for adequate dialysis? We do not yet have the answers. However, from now on in our daily practice, it is important to handle the peritoneal membrane with care, and to prescribe sufficient amounts of dialysis for patients to achieve better clinical results. |