Peritoneal Dialysis (PD) is an alternative form of dialysis, which differs from hemodialysis in that blood does not have to be brought outside of the body. Peritoneal Dialysis replaces the kidney’s work of cleaning the blood by using the lining inside your abdomen (belly) that surrounds your organs called the peritoneal membrane. Extra fluid and waste products your kidneys no longer get rid of travel across the peritoneal membrane into a special fluid called dialysate over a period of 4-6 hours. The dialysate enters and leaves your peritoneal membrane through a permanent catheter (tube) surgically placed in your abdomen. When you do PD you drain out the old dialysate and replace it with the new dialysate to begin the filtering process again (not unlike an oil change!).
Your PD clinic will train you to do PD safely and arrange for monthly delivery of all the supplies you will need to your home. You are responsible for checking your weight and blood pressure daily and calling your clinic when you have problems or questions. PD is done every day (usually 4-5 times a day) without exception. It is not necessary to be at home to do PD –you can do PD safely in a variety of settings.
In general, PD patients are seen twice a month in the clinic. At the first visit a nurse will draw your blood to check how well the dialysis is working. At the second visit you will meet with your doctor (Nephrologist), nurse, dietician and social worker to review your blood work and address your questions and concerns.
There are actually two ways of doing PD at home: Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cycling Peritoneal Dialysis (CCPD).
CAPD is…
CAPD is done 3-4 times a day simply by attaching your catheter to an empty bag and draining out fluid (dialysate); then refilling your abdomen with new clean fluid. This treatment is called an "exchange." Each exchange takes 30-45 minutes to complete and can be adjusted around your daily activities. When following certain guidelines, you can do CAPD safely at home, at work or while traveling.
CCPD is…
PD exchanges are done using a machine called a cycler, usually at night while you sleep. During CCPD you are connected to a machine that is programmed to do several exchanges while you sleep. CCPD works well for people who work during the day, have busy schedules, who need help with dialysis or those requiring 5 or more exchanges per day.
Advantages of PD…
- Dialysis is done in the comfort of your home.
- Greater independence—you can make your schedule as long as you do your treatment daily.
- Travel is easier.
- The diet is easier to manage than the diet for hemodialysis.
- No blood is involved in doing an exchange.
- Since dialysis is done daily and slowly, it is less stressful on your body than hemodialysis.
Disadvantages of PD
- Treatment is 7 days a week 365 days a year.
- You will have a catheter permanently place placed in your tummy that hangs on the outside of your belly.
- Weight gain is possible because the dialysate solution contains lots of sugar.
- Some risk of infection.
- Storage space is needed for all your supplies.
- You must eat a diet very high in protein.
Other helpful websites
- www.kidney.org
- kidneydirections.com
- henryford.com
- Nephron Information Center
- Life Options Rehabilitation Program
- www.kidneyoptions.com
- www.ikidney.com
- American Association of Kidney Patients
- American Kidney Fund
- National Institute of Diabetes, Digestive & Kidney Dis.
- National Kidney and Urologic Dis.
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