THE APPLICATION OF PERITONEAL DIALYSIS FOR THE THERAPY OF METABOLIC ALKALOSIS AND HYPERNATREMIA

Abstract

Seven patients with renal failure manifested metabolic alkalosis due to the drainage of gastric juice and vomiting. Hemodialysis was less effective for severe metabolic alkalosis and/or contraindicated for the patients with gastro-intestinal bleeding and postoperative wound. So peritoneal dialysis with CaCl₂- and KCl- added to physiological saline solution (PD-PSS) was used for the treatment. In result all the patients responded well to PD-PSS and there were no serious major complication. The basic idea to correct metabolic alkalosis by PD-PSS is to diffuse certain ions based on the chemical gradient at the peritoneal membrane as a semipermeable membrane. One out of the seven patients manifested hypernatremia and and hyperosmolemia caused by an excess amount of NaHCO₃ administration during cardio-pulmonary resuscitation. Peritoneal dialysis with hyposaline solution was used for the treatment and in result, the concentration of serum Na⁺ was decreased to normal range. These results suggest that peritoneal dialysis is an effective treatment for the diseases, especially metabolic alkalosis and hypernatremia.