What is the rule of thumb when it comes to advising patients on peritoneal dialysis as far as weight lifting restrictions? We usually advise our patients not to lift more than 25 pounds.

Questions About PD

Ana B., Nurse from Warr Acres, Oklahoma, USA asked
What is the rule of thumb when it comes to advising patients on peritoneal dialysis as far as weight lifting restrictions? We usually advise our patients not to lift more than 25 pounds.

1 answer

Nurse Canada with members of the ISPD Nursing Liaison Committee May 5, 2020

We thank you for your question. The authors of the recently published ISPD Guideline/Recommendation on peritoneal dialysis access note the following:

“Physical strain can be either an early or late cause of pericatheter leakage. Strenuous physical activities can force dialysate through the abdominal wall around the catheter…. Lifting limitations of 7 to 10 kg (15.5 – 22 pounds) are recommended for prevention, but weight and activity level are flexible based upon previous physical condition. The risk of leak can be minimized by performing sports and exercise activities with a dry abdomen” (1).
We would also suggest that this weight lifting limitation should be further reduced for a very small patient on PD. Other factors to take into consideration are previous abdominal surgeries and abdominal hernia(s) in limiting the weight to be safely lifted.

It should also be noted that, if the PD catheter is newly implanted, then the recommendations for activity are much more stringent. For example, Dr. Crabtree and co-authors recommend: “Avoid heavy lifting, stair climbing, straining, and constipation until catheter is healed (2 to 6 weeks)” (2).

1. 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 1;39(5):414-36. Available at: http://www.pdiconnect.com/content/39/5/414.full.pdf

2. Crabtree JH, Piraino B, Gellens M, Guest S, Firanek CA. Mancini A. Access Care and Complications Management Update 2017 – Care of the Adult Patient on Peritoneal Dialysis. Available at: https://qxmd.com/wp-content/uploads/2017/10/2017-Access-Guide-Care-and-Complications-Guide_Full-version_FINAL.pdf

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