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An increase in the lordotic curvature of the spine occurs with increased intra-abdominal pressure and poor muscle tone. It is not surprising then that low back pain is a common complaint among patients undergoing CAPD. The pain is the result of paraspinal muscle spasm, sciatica and posterior facet disease.
Treatment. General therapeutic measures include back education and exercises and judicious use of skeletal muscle relaxants and anti-inflammatory agents. Specific measures for PD patients are a decrease in dialysate volume and transfer to APD when indicated and reduction in exchange volume during the day to reduce intra-abdominal pressure. If all of these measures fail, an occasional transfer to HD may be required.
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