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Peritonealdialyse – ein ideales initiales Dialyseverfahren

Peritoneal dialysis – an ideal initial dialysis mode

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Zusammenfassung

Die Peritonealdialyse (PD) hat sich als Nierenersatztherapie neben der Hämodialyse (HD) etabliert. Obwohl die PD eine der HD gleichwertige Form der Dialyse darstellt, bleibt die Zahl der Dialysepatienten an der PD weltweit niedrig und nimmt in manchen Ländern sogar ab. Die Gründe dafür sind unterschiedlich. Manchmal ist das betreuende medizinische Personal zu wenig mit der PD vertraut, kann Patienten nicht ausreichend über die verschiedenen Dialyseverfahren informieren und erwirbt daher zu wenig Erfahrung mit PD. Es bestehen einige Bedenken, die PD verschiedenen speziellen Gruppen von Patienten trotz ausgezeichneter Ergebnisse hinsichtlich Dialysequalität und langem Erhalt der Nierenrestfunktion, niedrigeren Kosten als an der HD und besserer Lebensqualität vieler PD-Patienten im Vergleich zu HD-Patienten vorzustellen. PD sollte jedoch bis auf wenige Ausnahmen allen Patienten mit terminaler Niereninsuffizienz als initiales Dialyseverfahren angeboten werden. Dies schließt Diabetiker, Patienten mit Nierentransplantatinsuffizienz, Patienten mit Herzinsuffizienz sowie ältere Patienten ein.

Summary

Peritoneal dialysis (PD) has become an established dialysis modality besides hemodialysis (HD). Although PD is an equal form of dialysis compared to HD, patients numbers on PD remain low worldwide. There are several reasons for this fact. The medical staff in some centers is not used to PD, so there is not enough information about the different dialysis methods available for the patients and the staff doesn’t get the training that would be necessary to get familiar with PD. There are some concerns about offering PD to certain groups of patients despite excellent results as to quality of dialysis, good preservation of residual renal function, low costs compared to HD and better quality of life than on HD. However, PD should be offered to all patients requiring dialysis with very few exeptions as an ideal initial dialysis method. This includes patients with diabetes, patients with kidney transplant failure, patients with congestive heart failure and older patients.

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  1. Klinische Abteilung für Nephrologie und Dialyse, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich

    Heidi Puttinger

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Puttinger, H. Peritonealdialyse – ein ideales initiales Dialyseverfahren. Wien Med Wochenschr 163, 271–279 (2013). https://doi.org/10.1007/s10354-013-0200-x

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