Peritoneal dialysis removes waste and extra fluid through the blood vessels that line the walls of your abdomen. A membrane called the peritoneum covers the walls of your abdomen.
Peritoneal dialysis involves putting a soft, hollow tube (catheter) into your abdominal cavity and filling it with a cleansing fluid (dialysis solution). The solution contains a type of sugar that draws out waste and extra fluid. The waste and fluid passes from your blood vessels through the peritoneum and into the solution. After a set amount of time, the solution and waste is drained and thrown away.
The process of filling and draining your abdomen is called an exchange. The length of time the cleansing fluid remains in your body is called the dwell time. The number of exchanges and amount of dwell time depends on the method of peritoneal dialysis you use and other factors.
Your doctor will perform surgery to place the catheter in your abdomen where it will stay. It is most often near your belly button.
Peritoneal dialysis may be a good option if you want more independence and are able to learn to treat yourself. You will have a lot to learn and need to be responsible for your care. You and your caregivers must learn how to:
- Perform peritoneal dialysis as prescribed
- Use the equipment
- Buy and keep track of supplies
- Prevent infection
With peritoneal dialysis, it is important not to skip exchanges. Doing so can be dangerous to your health.
Some people feel more comfortable having a health care provider handle their treatment. You and your provider can decide what is best for you.
Types of Peritoneal Dialysis
Peritoneal dialysis gives you more flexibility because you do not have to go to a dialysis center. You can have treatments:
- At home
- At work
- While traveling
There are 2 types of peritoneal dialysis:
Continuous ambulatory peritoneal dialysis (CAPD) - For this method, you fill your abdomen with fluid, then go about your daily routine until it is time to drain the fluid. You are not hooked up to anything during the dwell period, and you do not need a machine. You use gravity to drain the fluid. The dwell time is usually about 4 to 6 hours, and you will need 3 to 4 exchanges each day. You will have a longer dwell time at night while you sleep.
Continuous cycling peritoneal dialysis (CCPD) - With CCPD, you are connected to a machine that cycles through 3 to 5 exchanges at night while you sleep. You must be attached to the machine for 10 to 12 hours during this time. In the morning, you begin an exchange with a dwell time that lasts all day long. This allows you more time during the day without having to do exchanges.
You can also use some combination of the two methods. Your provider will help you find the method that works best for you.
Your provider will monitor you to make sure the exchanges are removing enough waste products. You will also be tested to see how much sugar your body absorbs from the cleansing fluid.
Benefits of Peritoneal Dialysis Over Hemodialysis
- The patient controls his/her care
- The treatments can be performed in the patient's home
- Traveling is much easier
- The treatments are much more gentle, because dialysis occurs everyday, instead of three times a week
- The diet is much more liberal
- Clinic visits are only once a month after the initial training
Disadvantages of Peritoneal Dialysis
- There is greater risk of infection
- The patient must be able to perform their own treatments (trained family members can help)
- Not all patients are candidates for PD (example: multiple abdominal surgeries)