Peritoneal dialysis for acute renal failure after major abdominal surgery.

The efficacy and safety of peritoneal dialysis in the immediate postoperative period was evaluated by examining the course of 14 patients who were dialyzed 16 times, 4 to 18 days (mean 9 days) following major abdominal surgery. All patients had abdominal drains in place. Seven had abdominal aortic grafts, five had generalized peritonitis, four had active gastrointestinal bleeding, and ten were hypotensive at the time of treatment. The procedure was effective in all patients with improvement in biochemical factors and in the symptoms of the uremic syndrome. Serious complications (wound dehiscence) were observed in association with dialysis in only one patient. Four patients recovered completely; although the remaining ten died, in none was death due directly to uremia or one of its complications.