Like others, I still find the recommendations related to patients wearing gloves for PD procedures to be very unclear. Uptodate, CDC, and kidney.org all instruct patients to don gloves. Meanwhile, there is no apparent literature to support this recommendation. It would be very helpful if ISPD could provide recommendation or scholarly review that specifically recommends patients not using gloves.ANSWEREDMargaux N answered October 30, 2022
Good Morning,I am looking of standard of care information regarding the dispensing of peritoneal dialysis fluid in the hospital setting. Is it treated like medication and dispensed from the pharmacy or is it supplied through supply chain? Thank you in advance for any information you are able to provide me.ANSWEREDMichelle V. answered October 24, 2022
I am looking for information on power flushing PD catheters. There is very little evidence to support this practice. Does anyone have any information on this? How much can be flushed at a time? What are complications to look for?ANSWEREDChantyle L answered October 14, 2022
Can you draw vancomycin random level the day patient has his IP antibiotics, or you have to schedule it on a day that patient does not have the antibiotics. ThanksANSWEREDmary anne T answered October 11, 2022
Does ISPD cover current recommendations for how to perform an extension set change? For example scrub connection 2 minutes by sterile procedure, then soak 2 minutes. And do you do this closed system or open ended?ANSWEREDLaura C. answered September 15, 2022
How long can a PD Cat. Tube remain in place not being used before worring about infection?ANSWEREDRichard D Paoletti answered September 2, 2022
im working as a nurse and i have a patient doing pd dialysis 5 days per week and im preparing for kt/v for this patient .my question is do i need to calculate the dialysate for 5 days and renal for 7 days or i should follow the same formula regardless how many days the patient do pdANSWEREDhadi answered August 26, 2022
What is the most appropriate time frame to use when defining relapse, recurrent and repeat exit site infection?ANSWEREDCharon answered August 16, 2022
What does fibrin look like compared to protein. I was always taught fibrin looks like cooked egg whites and protein looks mucousy or like a little jelly fish.ANSWEREDKaren Dalton answered August 2, 2022
Good Morning, does anyone have any documented standards of practice for the the requirements inside a PD training room? Currently, I am in a hospital that is trying to put the PD clinic on the treatment floor in a isolation room, without a sink. There is no privacy, it is not quiet and it can be distracting, all the things not warranted for a PD training room.ANSWEREDLisa A. Cummings answered July 15, 2022
Can we use window dressing over peritoneal dialysis catheterANSWEREDMariam Awada answered June 1, 2022
Do you have any practice in the use of 4.25% solution in input by output (without permanence)? in the case of patients with acute pulmonary edema on peritoneal dialysis?ANSWEREDalexandra answered May 9, 2022
I have a patient who had a bowel obstruction while on PD who is on hemodialysis now. Do we continue to flush the PD catheter while on hemodialysis?ANSWEREDMary answered May 9, 2022
What is the definition of slow inflow and slow outflow in PD? What is the ideal time in which dialysate should run in and what is ideal time in which dialysate should be drained in CAPD and APD?ANSWEREDSalman Rouf answered April 29, 2022
I have a new PD patient keep having negative UF 24H urine output <500mL and became fluid overloaded after5 days had to do 1 time back up hemodialysis (he still has a fistula/had been on ICHD for 2 years) , days after I check and did an initial membrane test and resulted to high transport type (cant do PET yet he barely started) , decreased dwell time around 1.5 hours 2 days after changes reviewed treatment still every cycle he has about 3/5 cycles still negative UFs, I had removed last fill on the second prescription change that I did because that made this pt overloaded and absorbs it after long day dwell, what prescription would you recommend?ANSWEREDKimberly Flores answered April 22, 2022
What is the definition of a chronic exit site infection? In the 2017 ISPD guidelines for cath-related infections, it is written that in addition to removal, there are other interventions to treat refractory and chronic exit site infections. There is a clear definition of refractory exit site infection, but what is the difference between chronic and refractory exit-site infections?ANSWEREDCherry, J answered April 22, 2022
Can PD fluid be stored outside in a shed or garage? Historically patients store their fluid this way looking at the packaging it states "DO not Store below 4c"ANSWEREDCatherine answered April 8, 2022
In our home program, we have been practicing IP antibiotics administration for treatment for peritonitis on our PD patients. We have a new supervisor that is saying that we are not allowed as nurses to mix Abx with dianeal solutions and should be done by pharmacist. She has minimal experience with PD– performing exchanges for patients in an acute setting in the hospital. Has anyone ran into any of these issues before? Where can we find the answer and or source to show her that this is allowed practice?ANSWEREDMary C answered April 6, 2022
What is the dose of sodium bicarbonate and lidocaine is added to the dialysis solution to manage infusion pain?ANSWEREDMary Rose B. answered March 9, 2022
Does anyone have experience with bariatric surgery while the patiënt is on PD.Our surgions performed a uncomplicated lap. Gastric sleeve. Now they want to do a gasrtic bypass in a patiënt with a history of a sleeve.ANSWEREDM.a.m. Verhoeven answered March 8, 2022
Just want to find out if it’s only the regular insulin ( humulin R or novolin R) that can be added to the PD bag ( IP). If so, what’s the rationale? ThanksANSWEREDMary anne answered February 25, 2022
Is there a recommendation for those using a transfer set for it to be changed at the onset of peritonitis, with the initiation of IP/PO antibiotics vs changing at the end of the therapy course?ANSWEREDEllen B answered February 21, 2022
When you are not using your catheter right away. How frequently do you do irrigation and heparinization of your catheter in your pediatric population? Normally, we do ins/outs once a week and we heparinize the catheter post ins/outs. what is the longest time between ins/outs you have done. Did your patients developed fibrin or blockage..ANSWEREDPaule Comtois answered February 3, 2022
Baxter Healthcare recently sent out an Urgent Medical Device Correction notification (Jan 2022) regarding the MiniCap Extended Life PD transfer sets and the use of cleaning products causing damage if come into direct contact (hand sanitizer, hydrogen peroxide, bleach, alcohol, or antiseptic agents, solvents used to remove adhesive residue). It has been our policy to cleanse the exterior portion of the transfer set prior to connection and disconnection with Alcavis. Due to the recent notification we have stopped this practice but are hoping to find out what others are doing in replace of this practice. We have been told Povidone Iodine or soap and water are both acceptable to clean the transfer set and catheter. Patients that shower daily, this can take place while in the shower but what about the patients that are not bathing daily, what would be an alternative to cleaning the transfer set and catheter? Any thoughts or suggestions would be greatly appreciated.ANSWEREDCarla M. answered February 1, 2022
In the case of peritonitis patients who instill only 1L or 1.5L of dialysate, when antibiotics is prescribed as an intermittent dose 1g/IP, I am concerned about whether 1g should be mixed with 2L of dialysate or 1g should be mixed with only 1L or 1.5L of dialysate left.ANSWEREDMary Chung answered December 1, 2021
Do we still recommend antifungal agent in PD patient with AB therapy for UTI or exit site infection?ANSWEREDVyacheslav Melnikov answered November 15, 2021
Does anyone use acetic acid at the exit site during a pseudomonas infection, if so is there a reference for this?ANSWEREDKathryn E answered November 1, 2021
We recently presented the ISPD guideline of ruling out MRSA of the nares before the catheter is placed to our group of vascular surgeons. They voiced concerns for delaying treatment and patients access to care (adding additional appointments). What is the recommend process for following this guideline?ANSWEREDJessica S answered October 5, 2021
I have a 56 y patient on HD since 7 monthes , SLE , DM AND she is egar to shift to PD but she has 3 cesarean sections ( last one 17 y ago ) . can we proceed for PD cathter insertion or bitter to avoid because of possiblity of presence of intrabdominal adhesions ? and IF yes any advise before or after cathter insertionthanksANSWEREDbasem K answered October 5, 2021
I have a lady on PD who is scheduled for hysterectomy/Oopherectomy-she is not sure yet whether it will be Laparoscopic or otherwise.What are recommendations re Antibiotic prophylaxis and treatment post procedure pleaseThank youANSWEREDMeena K answered October 5, 2021
A peritoneal dialysis patient with an abdominal wall leak – we rest for two weeks and give oral antibiotic cover – what is the recommendation regarding this PD complication in regard to antibiotic cover.ANSWEREDKathryn answered September 14, 2021
Maximum amount of heparin that can be added per liter of dialysis solution.ANSWEREDFleta L P answered September 3, 2021
Hi, I have a patient with severe intellectual impairment who has ESRF and embarking on RRT. Swimming is enjoyable activity for this young man . His mum will be doing his dialysis and thought of doing HD is very overwhelming for mum. I wanted to know what are the recommendations around swimming and PD, once the exit site has healed. he will be swimming in both public and private pools. Is it an absolute contraindication? Can it be pursued with use of colostomy bags and meticulous exit site cares. Thanks for letting me know. ReshmaANSWEREDReshma Shettigar answered August 24, 2021
Is there any contraindication to insert pd catheter for patient with SLE who is on immune suppressive drugs as they are at high risk of infection??ANSWEREDGhada R. answered August 24, 2021
When a patient is on antibiotics for peritonitis, when is the proper timing to get samples for cultures. How much of a difference is there with obtaining a sample after 1 hour of dwell vs 6+ hours of dwell.ANSWEREDLoretta Bradford answered August 24, 2021
Is there a guideline on how patients on APD should check cloudiness of the effluent if they use drain line instead of drain bags? Thank you!ANSWEREDFei, T answered August 12, 2021
Hi just wondering could we use the last fill of PD cycle treatment from last night to obtain a PD fluid sample? or we need to instill new 1.5% PD solution for two hours and then get our PD sample for cell count and culture?ANSWEREDJennifer P answered July 29, 2021
I have a patient who has been hypotensive during routine flush. Minimal infusion 200ml and he is hypotensive dropping greater than 20 and symptomatic. I have never seen this before. Any ideas?ANSWEREDChristine m Smith answered June 22, 2021
When performing a PET, the standard dialysate fill volume for the dwell is 2000ml.What is the minimum dialysate fill volume that can be used for a PET?ANSWEREDDeborah Bauman answered June 16, 2021
If a patient presents with peritonitis, but within hours of presentation is subsequently found to have a ruptured bowel secondary to acute diverticulitis – should this still count towards a unit's peritonitis episodes?ANSWEREDLisa, P answered April 29, 2021
I am a nurse have been working in Dialysis for 10+ years. Is it appropriate to remove sutures for a PD exit site. I have orders from my nephrologist and orders and prn orders. Is this something a PD nurse very skilled is able to do?ANSWEREDNiki C answered April 23, 2021
My name is Petra Janasova- I work as a station nurse in the Department of Pediatric Nephrology at the Motol University Hospital at the 2nd Medical Faculty of Charles University in Prague.In the care of our doctors and nurses, patients are also dependent on peritoneal dialysis. I have been trying for some time to find out if someone has ever developed a standard of care for a peritoneal catheter – I am interested in the procedure of catheter dressing, care for it since its introduction to the patient. In the Czech Republic, a similar standard of nursing care (guideline) does not yet exist. The information I found on the internet is very strict.Can I ask you for information about peritoneal catheter care as you practice it in your medical facility?Thank you very much.Mgr. Petra JanasovaANSWEREDPetra Janasova answered April 19, 2021
I have a patient with bilateral patent processus vaginalis which was accidentally discovered while performing urgent-start PD and the caregiver placed him in an upright position which led to scrotal edema. The finding was confirmed by CT peritoneography. He underwent bilateral inguinal herniorrhaphy and currently shifted to hemodialysis. Is it safe to resume PD 4 weeks post-surgery? When resuming PD, should I start low fill volumes and shorter dwell time? Can I placed him right away to CAPD? Thank youANSWEREDMARY ROSE BISQUERA answered April 19, 2021
When connecting drain tubing to the PD catheter with a povidone iodine cap, is it necessary to soak the catheter connection or tip in antiseptic prior to connecting the tubing? Or is a no touch technique superior when the catheter has an antiseptic soaked cap? The latest Lippincott procedure instructs to soak the catheter tip in an antiseptic soaked gauze for 5 minutes before connecting the tubing. I understand cleaning the catheter with the cap still on prior to removing the cap and connecting to the tubing, but I can't find any rationale for doing this extra step of soaking the catheter tip.ANSWEREDAngela N answered April 15, 2021
I have a patient on Hemodialysis short term due to polymicrobial peritonitis requiring catheter removal. Patient is on maintenance warfarin but bridged over to Lovenox for insertion of new PD cath. Post op day 10 patient felt unwell, weak, SOB. Hemoglobin was 65 (INR 5.3) and patient was determined to have hemoperitoneum. CT has shown no active bleed and after 4 units PRBC's, hemoglobin has remained stable. Over a number of days we have drained a total of 3.5L blood from peritoneum through patients PD cath. Wondering if you have any recommendations. Should we be draining hemoperitoneum? When we determine it is fully drained is it ok to restart PD? Thank you.ANSWEREDJENNIFER,H answered April 2, 2021
is it possible for patient undergo for peritoneal dialysis and develop pleural leakage , meanwhile patient shifted to hemodialysis to back to PD and after how long if possibleANSWEREDAHLAM answered April 2, 2021
Is it advised to place IPN on hold during peritonitis infection?ANSWEREDSara D answered April 2, 2021
Why are dextrose based dialysing solutions still used if icodextrin is better?ANSWEREDSharon Tang answered March 24, 2021
For CAPD administration in hospitals, does your organization consider PD solution a medication? Do nurses verify the correct PD fluid through barcoding?ANSWEREDBenjamin S answered February 22, 2021
For treatment of Exit Site Granuloma, what is an alternative for silver nitrate? We do not have it in our country. Thank youANSWEREDAlona B answered February 19, 2021
