Lehmann Kijanosh, Reubke Benjamin, Wanninger Reinhard, Lindgren Manuela, Glowka Tim R, Kielstein Jan T, Eden Gabriele
Medical Clinic V, Nephrology, Rheumatology, Blood Purification, Academic Teaching Hospital Braunschweig, Germany.
Department of General and Visceral Surgery, Academic Teaching Hospital Braunschweig, Germany.
Clin Kidney J. 2025 Jan 6;18(2):sfae403. doi: 10.1093/ckj/sfae403. eCollection 2025 Feb.
Indications for peritoneal dialysis (PD) have undergone a paradigm shift in recent years. Medical barriers previously viewed as contraindications for PD such as anuria, autosomal dominant polycystic kidney disease, cardiovascular diseases or advanced age are increasingly re-examined. We learned that establishing a safe, functional and durable catheter access can be established even in patients with a variety of co-morbidities. Moreover, conditions that predispose to catheter-related infections and peritonitis are not as obvious as we thought. In this case-based review we present patients who have been performing PD for a long time and in whom PD might still be viewed unfeasible. The aim of the paper is to underline the importance of PD as a kidney replacement therapy with fewer medical limits than previously thought. It is also a plaidoyer for interdisciplinary and interprofessional collaboration. This 'Mission PD-possible' should be accompanied by a coordinated approach aligning policy, organizational structures and financial resources.
近年来，腹膜透析（PD）的适应症发生了范式转变。以前被视为腹膜透析禁忌症的医学障碍，如无尿、常染色体显性多囊肾病、心血管疾病或高龄等，越来越多地受到重新审视。我们了解到，即使是患有多种合并症的患者，也能够建立安全、功能良好且持久的导管通路。此外，易引发导管相关感染和腹膜炎的情况并不像我们想象的那么明显。在这篇基于病例的综述中，我们展示了长期进行腹膜透析且可能仍被认为不适合进行腹膜透析的患者。本文的目的是强调腹膜透析作为一种肾脏替代疗法的重要性，其医学限制比以前认为的要少。这也是一篇支持跨学科和跨专业合作的文章。这种“腹膜透析可行使命”应伴随着一种协调一致的方法，使政策、组织结构和财政资源保持一致。
