The use of peritoneal dialysis in special situations.

This brief review outlines several situations in which peritoneal dialysis (PD) can be used to address clinical situations that are out of the ordinary for end-stage renal disease (ESRD). For example, PD methodology can be used not only to treat ESRD patients with difficult psychosocial problems that obviate other dialysis options, but also to control ascites accumulation in patients with liver failure, to treat congestive heart failure in azotemic patients with progressive cardiomyopathy, to administer systemic medication via the peritoneal cavity, and to provide additional clearance in demanding circumstances. In discussing these unusual applications for PD, we open the door to extending the indications for PD to a broader spectrum of clinical problems.