From the Guidelines
Documented loss of peritoneal function is the absolute contraindication to peritoneal dialysis (PD).
Key Contraindications
- Documented loss of peritoneal function or extensive abdominal adhesions that limit dialysate flow
- In the absence of a suitable assistant, a patient who is physically or mentally incapable of performing PD
- Uncorrectable mechanical defects that prevent effective PD or increase the risk of infection as stated in the guidelines by the American Journal of Kidney Diseases 1. The rationale behind this is that PD efficiency relies on effective peritoneal blood flow, dialysate flow, sufficient peritoneal surface area, and permeability to allow adequate solute and fluid removal. Any compromise in these functions may result in inadequate peritoneal dialysis and thus the failure of PD, as explained in the study 1.
From the Research
Absolute Contraindications to Peritoneal Dialysis (PD)
- Recent abdominal or cardiothoracic surgery 2
- Diaphragmatic peritoneal-pleural connections 2
- Faecal or fungal peritonitis 2
Relative Contraindications to Peritoneal Dialysis (PD)
- High age 3
- Comorbidities such as diabetes mellitus, obesity, polycystic kidney disease, heart failure 3
- Previous history of abdominal surgery and renal allograft failure 3
- Presence of a ventriculoperitoneal shunt (VPS) is not an absolute contraindication, but requires careful consideration 4