Discomfort when solution flows in
- pH of the peritoneal dialysis solution
- Dialysis catheter position (mechanical)
What to do:
- Check if solution is warm. Warm solution to body temperature (if you use the cycler, the cycler will warm the solution to body temperature).
- Reduce infusion rate by lowering the bag or reduce the flow in the transfer set.
- Change your position during infusion (when solution is flowing in).
- Talk to your dialysis nurse about the discomfort during therapy.
- Your nurse may assess your catheter placement.
- Your nurse may add bicarbonate to the bag.
- There are other options of peritoneal dialysis solutions that could help with your discomfort during infusion. Ask your physicians or your nurse for further information.
Dialysis solution does not flow in or out
Possible causes and what to do:
|One or more clamps on the transfer set, CAPD bag lines (TwinBag lines) or automated peritoneal dialysis systems set may be closed.||Check to make sure all the clamps are open and the frangibles are broken.|
|The tubing or dialysis catheter is kinked.||Straighten out the tubing and the catheter.|
|The bag is not connected properly.||Push the luer all the way into the bag luer port.|
|The catheter, tubing or frangible is blocked by fibrin.||Gently squeeze the line or bend the frangible back and forth to loosen the fibrin and allow the fluid to pass. Complete your exchange and call your nurse to report fibrin presence.|
|Constipation.||It can be prevented by eating a healthy diet, exercise and the use of prescribed bowel medicines. Change your position to see if the flow of peritoneal dialysis solution changes. If this does not help the flow, contact your renal unit.|
|Air in the solution line.||Air can block the flow of solution. Close the transfer set clamp and gently squeeze the solution bag. This should move the air out of the line. Open the transfer set clamp and let the solution flow in.|
|Air in the automated peritoneal dialysis system patient line.||Call the 24-hour Baxter Technical Services telephone line.|
Drainage solution looks different
There are times when the drained fluid is not clear. There are reasons why this may happen.
|Drained fluid is cloudy.||Call your renal unit immediately. Do not wait for the next exchange. This could be an indication of peritonitis. Save the fluid in the drain bag.|
|Drained fluid has white strands in it.||This is an indication of fibrin. If fibrin is seen several times, notify your nurse to see if medication is required.|
|Drained fluid is pink.||This is an indication of a small amount of blood in your peritoneal cavity.|
|Menstrual.||Contact your nurse. You may need to add medication to the solution bag. If the pink colour gets darker or does not go away, call your dialysis unit immediately.|
|Heavy lifting or strenuous exercise.||Avoid heavy lifting or strenuous exercise. If the pink colour gets darker or does not go away, call your dialysis unit immediately.|
|The drained fluid is dark yellow.||The PD solution may have been left in the peritoneal cavity longer than usual. Dark yellow fluid may contain more waste products than normal. If it is clear, it is usually nothing to worry about.|
Peritonitis is an infection caused by germs in the peritoneal cavity. Most peritonitis events are preventable if you do your exchanges as you were taught every time.
What can you do to prevent peritonitis?
Consult your nurse if you think you have made an error in your technique.
Signs of peritonitis include:
Call your unit immediately—peritonitis will NOT go away by itself and is a serious condition.