Questions About PD
We thank you for your question. The latest “ISPD Guideline on Creating and Maintaining Optimal PD Access in the Adult: 2019 Update” in the section on Postoperative PD Catheter Flushing, the authors suggest a weekly flush, with 1000 units heparin per liter added to the irrigant to help prevent blood clots and fibrin plugs. This procedure will also detect malfunction early. The authors note further that if the catheter is still not being used after the first month post-operatively, flushing can be continued but once every 2 – 4 weeks (1).
From a small survey of members of the ISPD Nursing Liaison Committee, we found that practices vary from country to country. Some home PD units do not add heparin to the flush, while some add 500 – 1000 units of heparin per liter of fluid. As noted in a previous response to a similar question on this website (January 23, 2009), flushing the PD catheter at regular intervals when it is not being used, as well as checking for patency and function, allows the nurse to inspect the PD catheter exit site and monitor that the patient is still performing routine PD catheter exit-site care.
- Crabtree JH, Shrestha BM, Chow KM, Figueiredo AE, Povlsen JV, Wilkie M, Abdel-Aal A, Cullis B, Goh BL, Briggs VR, Brown EA. Creating and maintaining optimal peritoneal dialysis access in the adult patient: 2019 update. Peritoneal Dialysis International. 2019 Sep;39(5):414-36. Available at: https://journals.sagepub.com/doi/pdf/10.3747/pdi.2018.00232