Fluid overload is an important problem in peritoneal dialysis (PD) patients, especially when residual urine production is absent. It may be caused by a high fluid intake, inappropriate PD prescription, noncompliance, or by a low drained volume. The latter can be due to mechanical problems, such as catheter dislocation or subcutaneous leakages, or to peritoneal membrane failure. When the diagnosis of ultrafiltration failure is based on a clinical definition, all the above causes of overhydration are included, which might lead to overdiagnosis. Underdiagnosis is also possible, for instance, when a patient with impaired peritoneal ultrafiltration remains in a good hydration status because of strict adherence to a severe salt and fluid restriction. Hence, when faced with a disruption of volume homeostasis, the clinician needs to determine where the fault lies: is it failure of the peritoneum to respond to an adequate osmotic stimulus, or the failure of the prescription to provide such an osmotic stimulus, or the failure of the patient to comply with dietary restrictions and guidelines.


Peritoneal Dialysis Continuous Ambulatory Peritoneal Dialysis Residual Renal Function Peritoneal Membrane Fluid Removal 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Medical Sciences, Research and DevelopmentAstellas Pharma, USDeerfieldUSA
  2. 2.Department of Nephrology, Academic Medical CenterUniversity of AmsterdamNetherlands

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