Outcome of Peritoneal Dialysis in the Management of Acute Renal Failure

Jesu Antony Azhil Arasu, M (2007) Outcome of Peritoneal Dialysis in the Management of Acute Renal Failure. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION: Acute Renal failure is a reversible disorder. It should be detected early and treated promptly by correction or removal of the precipitating factor. Management may include conservative measures or dialysis depending on the severity of the renal impairment and resulting complications. Haemodialysis necessitates constant attendance of the trained professional and technical personnel, costly equipment heparinisation of the patients and surgical placement of arterial and venous catheters. At least two or three hours of preparations are needed before starting the dialysis, so its usage and utility is restricted even in the secondary centers. Peritoneal dialysis is a simple, safe, effective and relatively less expensive and alternative procedure in renal failure, especially acute renal failure. It does not require expensive instruments and trained technicians and can be performed by anyone at any center which can save many lives. With the above considerations, the present study was undertaken to evaluate the efficiency and to record the complications of intermittent peritoneal dialysis in the management of acute renal failure. AIMS OF THE STUDY: 1. To study the age and sex distribution, various clinical presentation of acute renal failure. 2. To analyze the various etiologies of acute of renal failure. 3. To analyze the complications of peritoneal dialysis. 4. To assess the therapeutic outcome and efficacy following peritoneal Dialysis. MATERIALS AND METHODS: The study was conducted on 65 patients of acute renal failure admitted in the medical and nephrology wards of the Govt. stanley medical college Hospital for treatment from November 2005 to July 2006. All the patients were thoroughly evaluated by detailed history, clinical examination, biochemical parameters, ultrasonogram, peritoneal fluid cell count and culture as per preformed proforma. Various pre and post dialysis investigations included the following: (1) total and differential count, haemoglobin, (2) clotting time, (3) Blood urea, (4) Serum creatinine, (5) Blood sugar, (6) Serum electrolytes, (7) urine analysis, (8) X-ray chest and abdomen. Selection Criteria: The following criteria were used for selection of patients with acute renal failure. 1. Rapid reduction of Glomerular filteration rate leading to sudden and progressive elevation of Blood Urea > 40 mg/dl and or serum creatinine >1.5 mg/dl. 2. Normal sized or Enlarged Kidney revealed by ultra sonogram. 3. Absence of pre existing renal disease. Exclusion Criteria: The patients with Bilateral contracted kidneys on ultrasonogram. Methodology adopted in Peritoneal Dialysis: The total of 84 procedures of intermittent peritoneal dialysis were performed and the frequency being 1 to 3 per person with duration of 24 hours per sitting. CONCLUSION: 1. Majority of Patients of Acute Renal Failure belong to the Age Group of 20-40 Years. 2. The Incidence of ARF was Higher in Males than Females. 3. In this Series Most Common Etiology of Acute Renal Failure is Acute Gastro Enteritis. 4. The Most Common Presentation of Acute Renal Failure is Oliguria. 5. The Most Common Complication of Peritoneal Dialysis is Abdominal Discomfort and Pain. 6. No Incidence of Perforation of Gut in this study. 7. Intermittent Peritoneal Dialysis is Relatively Less Costly, Requires No Need of Constant Attendance of Trained Professional and Technical Personnel. 8. In this Series the Intermittent Peritoneal Dialysis has proved to be Readily Available, Simple, Safe, and An Effective Adjunct to the Treatment of Patients suffering from Acute Renal Failure.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Peritoneal Dialysis ; Outcome ; Management ; Acute Renal Failure.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 23 Mar 2018 04:16
Last Modified: 24 Mar 2018 05:45
URI: http://repository-tnmgrmu.ac.in/id/eprint/6451

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