What Is Peritoneal Dialysis?
Peritoneal dialysis (PD) is a treatment for kidney failure that uses blood vessels in the lining of your abdomen—the peritoneum—to naturally filter waste from your blood. During PD, a cleansing solution called dialysate is sent through a PD catheter to your peritoneal (abdominal) cavity, where it absorbs waste and toxins from blood vessels in the peritoneum, and is then drained back out and discarded.
PD is typically done at home or in any other clean, enclosed environment. PD treatments are done more frequently, so waste and toxins in your blood don’t have a chance to build up as much between treatments. Home peritoneal dialysis may also mean fewer food restrictions and less medication.
How does peritoneal dialysis work?
During peritoneal dialysis, dialysate fluid is placed into your peritoneal cavity via a peritoneal catheter—either manually or by using a machine called a cycler. This process is called filling. The fluid then stays in your peritoneum for a period called “dwell time,” during which the dialysate absorbs the waste, toxins, and excess fluid from your blood that your kidneys can no longer filter out. When the dialysate is drained from your peritoneal cavity, the waste, toxins, and excess fluid are removed along with it. The completion of this peritoneal dialysis procedure—filling, dwelling, and draining—is called an exchange.
Are there different types of peritoneal dialysis?
There are 2 types of peritoneal dialysis: continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD). Both types of peritoneal dialysis have the same basic function, but each have their own methods and advantages to consider.
Continuous ambulatory peritoneal dialysis—is done without a machine, and requires 3 to 5 exchanges per day. The benefit to CAPD is that it allows you to manage your dialysis from home, work, or while traveling.
Automated peritoneal dialysis—also known as continuous cycling peritoneal dialysis (CCPD), uses a machine called a cycler to perform each exchange. CCPD can be done as one long session on the cycler while you sleep or multiple shorter sessions-using the cycler just to drain and fill-throughout the day.
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What are the benefits of peritoneal dialysis?
When considering dialysis, peritoneal options may be the first method your doctor suggests for a number of reasons. Home PD may be right for you if you work, go to school, travel, or enjoy flexibility during the day. There are a variety of other benefits of home PD as well:
- You can do peritoneal dialysis (PD) at home without assistance—while still having regular monitoring and a 24/7 on-call PD nurse via phone.
- You have the flexibility of making your own schedule—and you can do PD almost anywhere—at work, at home and while traveling. All you need is a space that is well lit, clean and indoors.
- PD may help preserve remaining kidney function—if started early.
- There are no needles used during PD treatment—and treatments are generally painless and may involve fewer medications.
- You won’t have to travel to and from the center for dialysis treatment—which will give you more free time.
- You have more freedom to work and be social—thanks to a more flexible schedule. You can even do PD in your sleep.
- PD is considered to be gentler on your body—including your heart. You may experience fewer side effect than with other forms of dialysis.
Consider home peritoneal dialysis
Home PD is closest to natural kidney function. Find out if it may be a good option for you.
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Both home dialysis options offer 24/7 on-call nursing coverage by phone. Plus, regular check-ins with your care team.
“PD offers the most flexibility. It’s the easiest to learn.”
Factors to consider with home peritoneal dialysis
- A peritoneal catheter (a soft, flexible tube) will be surgically placed in your abdomen.
- Typically, PD catheter surgery is a minor operation that takes less than one hour. You will likely be placed under general anesthesia and go home the same day.
- After your PD catheter is placed, you will need to avoid swimming, bathing, or showering for 2 weeks, or according to your care teams instructions. This is to protect the dressings from the operation during recovery, as they are not waterproof. You may use a washcloth or sponge to clean your body, while ensuring your PD catheter access site remains dry.
- You’ll receive detailed training at your center to ensure you feel comfortable doing PD on your own. You’ll also learn proper PD catheter care.
- Following certain precautions will help you avoid the risk of an infection called peritonitis. Your nurse will give you instructions on how to avoid infection.
- You will need ample storage space for your supplies.
- If you have diabetes, know that your doctor may need to adjust your dose of insulin. That’s because the sugar in the dialysis fluid may make your blood sugar levels higher and cause weight gain.
- You should expect to do treatments every day, 7 days a week—as prescribed by your nephrologist.
- You will visit your clinic once or twice a month for laboratory testing and check-ins with your doctor and care team.
Time needed to do peritoneal dialysis
The time needed to do peritoneal dialysis may depend on the type of PD you choose. For instance, since CAPD is continuous, you’ll need to give yourself time for your treatment (draining or filling) throughout the day. In the peritoneal dialysis procedure, draining takes about 15-20 minutes; filling takes about 10 minutes.
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Peritoneal dialysis complications to know about
- Infection: There’s a possibility of infection inside your peritoneum while on peritoneal dialysis—a condition known as peritonitis. You could also develop an infection around your access site, where the catheter is inserted. Proper hygiene and access site care can help avoid infection.
- High blood sugar: If you have diabetes, the dextrose found in some types of dialysate may cause your blood sugar levels to go up. Talk to your doctor about whether you’d need to make any adjustments to your diabetes care when doing PD.
- Weight gain: The dialysate solution used during peritoneal dialysis contains dextrose—a type of sugar—which may cause your body to take in extra calories throughout the day, leading to weight gain.
- Hernia: After your PD access surgery, it’s important to avoid lifting anything heavy, climbing stairs, or straining your abdominal muscles for at least 6 weeks or as recommended by your doctor to lower the possibility of developing a hernia.
- Ineffective dialysis: Over time, peritoneal dialysis may not work as well and your doctor may recommend that you switch to hemodialysis.
If you have any questions or concerns about complications related to PD, talk to your care team. We are here to help.
Is peritoneal dialysis right for me?
While most people are candidates for PD, not everyone is. If you’ve had several abdominal surgeries or your peritoneal lining isn’t intact, it may not be possible. Be sure to tell your doctor about past surgeries and ask what choices are the best ones to consider. Always feel free to ask questions. This is a decision you’ll want to feel good about.