On March 13th, on the eve of the 19th World Kidney Day, the whiter conducted an exclusive interview with Chen Wen, a renowned kidney disease treatment specialist and the Head of Nephrology Department at Hainan Chengmei Hospital. The interview focused on raising awareness about advanced kidney replacement therapy methods, particularly the technique of peritoneal dialysis.
Chen Wen explained that currently there are generally two methods of dialysis: hemodialysis and peritoneal dialysis. Hemodialysis involves extracting the patients blood, purifying it outside the body, and then returning it back into the patient’s body. On the other hand, peritoneal dialysis utilizes the bodys own peritoneal membrane as a "natural filter." It involves the repetitive infusion of sterile dialysis fluid into the abdominal cavity to circulate and cleanse, with the goal of removing toxins, metabolic waste products, and excess fluids from the body.
Currently, with advances in medical technology and the support of various new techniques, the advantages of peritoneal dialysis have become evident, making it one of the important treatment modalities for patients with end-stage renal disease.
Director Chen Wen
The introduction of new peritoneal dialysis solutions has provided even more benefits for patients
Traditional peritoneal dialysis solutions mainly adopt glucose as the osmotic agent. However, glucose has a relatively small molecular weight, which makes it easily absorbed by the body and can lead to disruptions in lipid and carbohydrate metabolism. Additionally, as the dwell time of glucose in the peritoneal cavity increases, the filtration capacity of the solution decreases.
At present, icodextrin solution, a new type of peritoneal dialysis solution, has been launched on the domestic market. It effectively addresses the limitations of glucose-based peritoneal dialysis solutions.
According to Chen Wens introduction, due to its larger molecular weight, icodextrin solution is not easily absorbed by the peritoneum. It can provide a dwell time of up to 16 hours, allowing for more efficient removal of toxins and fluid, greatly improving the dialysis efficiency. Additionally, as it does not contain glucose, it can help improve patients lipid and carbohydrate metabolism, effectively reducing the risk of cardiovascular disease and mortality.
It is reported that icodextrin solution was first launched in Europe in 1997. Since then, it has accumulated a wealth of clinical experience globally and has been recommended by authoritative guidelines both domestically and internationally.
Promoting APD technology to make dialysis more convenient
With the increasing prevalence of peritoneal dialysis, a more convenient and efficient method called Automated Peritoneal Dialysis (APD) has emerged. In recent years, the number of patients receiving APD treatment has been increasing, showing a trend of growing. Especially during the COVID-19 pandemic, the utilization rate of home-based APD has significantly increased.
Chen Wen explained that compared to traditional dialysis modes, APD has more pronounced treatment advantages. Not only does it improve dialysis efficiency and reduce the risk of infection, but it also offers a flexible treatment schedule. Patients can undergo dialysis at home during the night, avoiding the impact on their normal work and daily life during the day.
In particular, APD has been upgraded with remote monitoring capabilities, meeting the needs for remote medical supervision and guidance for patients undergoing home treatment. This reduces the number of in-person visits for patients and lowers the risk of cross-infection in public areas. It makes the treatment more intelligent, safe, precise, and efficient.
Improving the percutaneous puncture catheter placement technique enhances the safety of dialysis
Chen Wen explained that a good peritoneal dialysis catheter placement technique is an essential prerequisite for effective and long-term maintenance of peritoneal dialysis. It can help reduce the occurrence of complications such as catheter dysfunction and infection.
Currently in China, the common techniques for peritoneal dialysis catheter placement include open surgery and laparoscopic placement. As a modified catheter placement technique, percutaneous puncture method can be completed by simple puncture operation, which has many advantages such as simple operation, local anaesthesia, small trauma, short time of tube placement and less bleeding.
The development and promotion of percutaneous puncture catheter placement technique can help more end-stage renal disease patients receive safe and effective peritoneal dialysis treatment.
Chen Wen stated that currently, with the development and promotion of APD, the application of new treatment regimens brought by innovative peritoneal dialysis solutions, and the widespread use of modified percutaneous puncture catheter placement technique, the overall level of peritoneal dialysis technology has been significantly improved.
Recently, the Nephrology Department of Hainan Chengmei Hospital has started offering routine services such as Automated Peritoneal Dialysis (APD) and modified percutaneous puncture catheter placement technique, providing a more diverse range of treatment options for renal disease patients.
Introduction of the expert
Next and picture(s) from Chen Lin