Do you take any special considerations for a patient with ESKD who has an ileostomy/colostomy and wishes to start peritoneal dialysis?

My special considerations are to probably avoid PD. But it depends on what the surgical history was for that ileostomy or colostomy, e.g., there may be a lot of scar tissue. When PD works (flows easily in and out), it works; when it doesn',t it doesn't and if doesn't it usually doesn't get better (4 doesn't). I think that makes my point.

If I were to do PD, I would discuss exit site placement with whoever puts it in and make sure it is FAR as possible from the ostomy. Personally, I just think yo...

A pre-sternal PD catheter is perfect for such situations (ileostomy/colostomy). The catheter exit site is located in the parasternal area, thus avoiding the abdominal area. In addition to ostomies, the catheter is particularly useful in obese patients, children with diapers and fecal incontinence, and patients who want to take baths without the risk of exit contamination.

• Twardowski, PMID 12085389