Acute central hemodynamic effects of peritoneal dialysis

Abstract

Background: The supposed lack of a hemodynamic impact of peritoneal dialysis (PD) has been challenged recently in different studies, although the observed effects are still far below those seen on hemodialysis (HD), and the underlying mechanisms are unclear. Methods: Literature overview based on Pubmed search with key words 'peritoneal dialysis, acute dwell, hemodialysis'. Discussion: Hemodynamic effects of an acute PD dwell seem to be consistent, but rather limited. Increasing peritoneal pressure, causing enhanced preload and thus better cardiac output, and vasoactive reactions induced by incompatibility of the dialysis fluid seem to be the most prominent causes. The role of hyperglycemia is a matter of debate. In view of the repetitive character of the insults, especially during APD, more in depth investigation of this phenomenon is warranted. Copyright © 2009 S. Karger AG, Basel.