December 1958

Peritoneal Dialysis and Newer Methods of Intestinal Perfusion in Renal Failure

Author Affiliations

Kansas City, Kan.

From the Department of Surgery, University of Kansas School of Medicine.

AMA Arch Intern Med. 1958;102(6):914-921. doi:10.1001/archinte.1958.00260230060008

Because qualified personnel and necessary equipment are not universally available for the use of hemodialysis in the complications of acute renal failure, evaluation of other methods for the management of this problem is appropriate. The purpose of all methods of dialysis is the selective removal of retained metabolites, with correction and maintenance of water and electrolyte homeostasis. This is achieved in greater or less degree by gaining access to and modifying the composition of extracellular fluid. Cellular membrane transfers extend these beneficial effects to favorable changes in body composition.

During the oliguric phase of acute renal failure, potassium intoxication and pulmonary edema are the greatest potentially lethal factors.1 Hyperpotassemia is accentuated by acidosis which is related to accumulation of anions, including phosphate, sulfate, and organic anions. Measures to correct this metabolic acidosis by withholding chloride ion, by allowing the extracellular chloride concentration to fall,2 and by administering sodium

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