Current concepts in peritoneal dialysis.

Peritoneal dialysis has been increasingly employed to treat patients with end-stage renal failure. Solute transport can be enhanced by increasing ultrafiltration with hypertonic dialysate, infusing intraperitoneal vasodilators to increase the effective surface area for exchange, and by employing new methods of dialysate delivery which may improve dialysate mixing and decrease the effective membrane resistance to solute flux. While infection remains a major complication of peritoneal dialysis, techniques to prevent and treat infections have been effectively employed. Progress has also been made in the treatment of diabetic patients with peritoneal dialysis. Continuous ambulatory peritoneal dialysis, a relatively new technique with fast growing clinical application, may be the therapy of choice for many patients with end-stage renal failure.