Peritoneal Dialysis

Peritoneal Dialysis

The Peritoneal Dialysis curriculum allows the learner to practice performing peritoneal dialysis in multiple clinical scenarios over varying pediatric ages (infant, child and adolescent) and disease states (acute kidney failure, chronic kidney failure, sepsis, peritonitis, congenital malformations), providing real-time feedback for learner actions. The curriculum includes a pre-test, interaction with our peritoneal dialysis simulator, and a post-test.  

The simulator promotes a systematic approach in response to problems and complications that arise while a patient is being managed on peritoneal dialysis. The learner virtually diagnoses conditions and complications, manipulates the PD set-up and prescription, and administers medications. The simulator is organized into sections:

  1. Knowledge guide: A primer on peritoneal dialysis that includes interactive text-based sections and some short videos
  2. Tactics: Short case-based problems to virtually diagnose and manage  
  3. Case simulations: Less-directed cases that push learners to care for a variety of simulated patients over a longer amount of clinical time, making decisions regarding diagnostics, testing, and treatment

Learning Objectives

  • Explain key basic science-based definitions (dialysis, osmosis, diffusion, convection, membrane properties)
  • Understand concepts that influence PD delivery, and apply these to management of PD clinically (indications and contraindications, ultrafiltration, clearance, and infection control)
  • Discuss and manipulate the various components of a PD prescription (sodium, potassium, dextrose, heparin, antibiotics, fill time, drain time, dwell time, cycle number, fill volume) in response to different patient scenarios, including as a given patient’s needs change over time
  • Apply a systematic approach to evaluating each patient, including physical exam, effluent evaluation, laboratory and fluid balance results evaluation, and assessment of the PD set-up
  • Recognize and respond to physical exam, effluent, laboratory results, fluid balance results, and technical aspects of the PD set-up, including diagnostic testing and management
  • Understand key mechanical aspects of PD delivery, including include movement of fill bag and drain bags, clamping and unclamping of catheters
  • Understand when to deliver, and when to avoid, common medications used with PD (sodium supplementation, intraperitoneal antibiotics, and fibrinolytics)
  • Recognize and manage key common patient-specific complications (dehydration, peritoneal catheter leak, peritonitis, and poor ultrafiltration)
  • Recognize and manage key common electrolyte abnormalities (hyperkalemia, hypokalemia, hyponatremia)
  • Recognize and manage key common mechanical complications (catheter obstruction, clamped catheter, inadequate fill bag height, inadequate drain bag height)

Curriculum Director

Traci Wolbrink, MD, MPH

Contributors

Aleksandra E. Olszewski, Daniel Hames, MD, Mignon McCulloch, MD, Deborah Stein, MD, Sharon W. Su, MD, Traci A. Wolbrink, MD, MPH

Suggested Audience

  • Physicians
  • Nurses

Release Date

  • Released: 1/28/2016