Dianeal is a sterile peritoneal dialysis solution. It comes in UltraBag containers and is used for patients who have chronic renal failure and who are on dialysis, in cases where no other treatment is viable. It is only to be administered into the abdominal cavity during dialysis, and is not to be given by injection. It does not contain any bacteriostatic or antimicrobial agents, but does contain povidone-iodine. Two liters of Dianeal solution are instilled into the abdominal cavity of the patient, and then the access device is clamped, allowing the solution to remain in the abdominal cavity for four to eight hours during the day, and eight to twelve hours overnight. It is repeated three to five times per day, six to seven days per week.
Some side effects of Dianeal happen because of mechanical problems, solution problems, as the result of contamination of equipment or improper technique in placing the catheter. Some of these effects can include abdominal pain, bleeding, skin infections around the catheter entry site, infections of the site itself, blockage of the catheter, difficulty in removing fluids, inflammation of the lining of the abdominal cavity, obstruction of the intestines, imbalances of your electrolytes and fluids, high or low blood pressure, an increase or decrease in your blood plasma level, allergic symptoms, and muscle cramps.
When administering Dianeal, it is important to use aseptic technique in order to avoid infection of the administration site. In addition, improper technique could result in the introduction of air into the abdominal cavity. Some patients require special care when being given Dianeal for dialysis; if you have had your peritoneal membrane or your diaphragm disrupted by abdominal surgery or trauma, bowel distention, abdominal disease or infection, hernias, burns, fecal fistula or colostomy, abnormal build-up of fluid in the abdomen, obesity, aortic graft replacement, an excess of lactic acid in the body, or severe pulmonary disease, your doctor should exercise extreme caution in putting you on dialysis and using Dianeal in the procedure. An accurate record of the fluid balance in the abdominal cavity must be kept at all times, and the patient must be carefully monitored to make sure enough fluids, though not too much, are administered. Otherwise, the patient may experience extreme side effects including congestive heart failure, volume depletion, and shock. In addition, you should be monitored to make sure your levels of serum electrolytes, magnesium, and bicarbonate are where they should be.
Dianeal is in Pregnancy Category C, which means that it has not been evaluated for safety during pregnancy, and it is not known whether it will harm a fetus or complicate a pregnancy. No animal or human studies have been conducted. It is advised that extreme caution be used when administering Dianeal to a pregnant woman. It is also not known whether Dianeal passes into breast milk, so caution is advised in this circumstance as well. Dianeal has not been tested for children and is not recommended for pediatric use.
Review published on: 13 June 2008
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