Peritoneal Dialysis

Overview

If you have kidney failure, peritoneal dialysis works to clear waste and extra fluid from your blood, replacing the work your kidneys used to do. One type of dialysis, hemodialysis uses a machine to filter your blood. Peritoneal dialysis, on the other hand, filters your blood through the lining of your abdominal cavity, at your convenience at home.

What to Expect from Peritoneal Dialysis

If you and your physicians have agreed that this is an appropriate option for you, you will undergo a minor surgical procedure to have a catheter (plastic tube) placed in your abdomen. Once you are healed from the surgery, you will start performing the dialysis.

Frequency of dialysis

Depending on your medical needs, you and your care team will determine the peritonal dialysis process that is best for you. This includes the number of exchanges (removal of fluid and refilling the abdominal cavity with fluid) per day, the type and volume of fluid (dialysate) to be used, and whether a machine will be used to perform the fluid exchanges. Since you will be doing this at home, you’ll also be taught the process. It’s important that you stick to the schedule that was set up for you and not miss any scheduled exchanges.

Types of peritoneal dialysis

There are two types of peritoneal dialysis:

• Continuous ambulatory peritoneal dialysis (CAPD): This is the type of dialysis that does not use a machine, but filters your body’s waste through your peritoneum (lining of the abdominal cavity). During dialysis, a cleansing solution (dialysate) will flow into your body through the catheter, guided by gravity. Dextrose (sugar) in the dialysis fluid draws waste and fluids through the peritoneum (abdominal lining) and into the abdominal cavity. This process of emptying out the fluid in the abdominal cavity and refilling it with fresh fluid takes 30 – 40 minutes. When you drain the fluid out through the catheter the waste and excess fluid goes with it. A typical plan calls for three or four exchanges during the day and one overnight. You can walk around during this dialysis and maintain your daily routine.
• Automated peritoneal dialysis (APD). For this type of dialysis you will have a machine called a cycler to perform the exchanges. One benefit to APD is that it can take place while you sleep, usually over the course of three or four fluid exchanges. In the morning, you start a new exchange. The dialysis fluid stays in your abdomen all day and when you go to bed the cycler will resume the process of additional exchanges overnight. The machine is equipped with an alarm to alert you of any problems with the inflow or outflow of the dialysis solution.

Questions to Ask Your Provider About Peritoneal Dialysis

You will probably have a lot of questions about dialysis and your care. Here are a few to get you started:

• Is this type of dialysis the best for me? What are the pros and cons of each type?
• Is it difficult to learn?
• Can I leave the house while doing dialysis?
• How will I know if it is working?
• What signs/symptoms should I watch for? What if I don’t feel I can do this on my own?