KEY ACTIVITIES
Inflow pain can be due to mechanical causes or to the effects of solution temperature or pH. Inflow pain usually subsides gradually after filling is complete. For abdominal discomfort during inflow:1
- Change position during infusion
- In CAPD patients, reduce dialysis infusion rate by lowering the IV pole or partially closing the transfer set clamp; in APD patients, adjust fill rate or program cycler to deliver modified tidal (85%–90%)
- Ensure proper warming of dialysis solution
- Treat constipation
- Investigate PD catheter position—flat plate of abdomen
- Reposition PD catheter if unresolved as necessary
- Check shelf life of used dialysis solution
- While addition of small amounts of bicarbonate and lidocaine have been added to solutions to treat infusion discomfort, these additions to the bag are a peritonitis risk and have not been rigorously evaluated
