Peritoneal dialysis
What is peritoneal dialysis and how does it work?
Peritoneal dialysis is a treatment for kidney failure that uses the lining of your abdomen, or belly, to filter your blood inside your body. Health care providers call this lining the peritoneum.
A few weeks before you start peritoneal dialysis, a surgeon places a soft tube, called a catheter, in your belly.
When you start treatment, dialysis solution—water with salt and other additives—flows from a bag through the catheter into your belly. When the bag is empty, you disconnect it and place a cap on your catheter so you can move around and do your normal activities. While the dialysis solution is inside your belly, it absorbs wastes and extra fluid from your body.
After a few hours, the solution and the wastes are drained out of your belly into the empty bag. You can throw away the used solution in a toilet or tub. Then, you start over with a fresh bag of dialysis solution. When the solution is fresh, it absorbs wastes quickly. As time passes, filtering slows. For this reason, you need to repeat the process of emptying the used solution and refilling your belly with fresh solution four to six times every day. This process is called an exchange.
You can do your exchanges during the day, or at night using a machine that pumps the fluid in and out. For the best results, it is important that you perform all of your exchanges as prescribed. Dialysis can help you feel better and live longer, but it is not a cure for kidney failure.
How will I feel when the dialysis solution is inside my belly?
You may feel the same as usual, or you may feel full or bloated. Your belly may enlarge a little. Some people need a larger size of clothing. You shouldn’t feel any pain. Most people look and feel normal despite a belly full of solution.
What are the types of peritoneal dialysis?
You can choose the type of peritoneal dialysis that best fits your life:
- continuous ambulatory peritoneal dialysis (CAPD)
- automated peritoneal dialysis
The main differences between the two types of peritoneal dialysis are
- the schedule of exchanges
- one uses a machine and the other is done by hand
If one type of peritoneal dialysis doesn’t suit you, talk with your doctor about trying the other type.
CAPD doesn’t use a machine. You do the exchanges during the day by hand.
You can do exchanges by hand in any clean, well-lit place. Each exchange takes about 30 to 40 minutes. During an exchange, you can read, talk, watch television, or sleep. With CAPD, you keep the solution in your belly for 4 to 6 hours or more. The time that the dialysis solution is in your belly is called the dwell time. Usually, you change the solution at least four times a day and sleep with solution in your belly at night. You do not have to wake up at night to do an exchange.
Automated peritoneal dialysis. A machine does the exchanges while you sleep.
With automated peritoneal dialysis, a machine called a cycler fills and empties your belly three to five times during the night. In the morning, you begin the day with fresh solution in your belly. You may leave this solution in your belly all day or do one exchange in the middle of the afternoon without the machine. People sometimes call this treatment continuous cycler-assisted peritoneal dialysis or CCPD.
Where can I do peritoneal dialysis?
You can do both CAPD and automated peritoneal dialysis in any clean, private place, including at home, at work, or when travelling.
Before you travel, you can have the manufacturer ship the supplies to where you’re going so they’ll be there when you get there. If you use automated peritoneal dialysis, you’ll have to carry your machine with you or plan to do exchanges by hand while you’re away from home.
How do I prepare for peritoneal dialysis?
Surgery to put in your catheter
Before your first treatment, you will have surgery to place a catheter into your belly. Planning your catheter placement at least 3 weeks before your first exchange can improve treatment success.
Although you can use the catheter for dialysis as soon as it’s in place, the catheter tends to work better when you have 10 to 20 days to heal before starting a full schedule of exchanges.
Your surgeon will make a small cut, often below and a little to the side of your belly button, and then guide the catheter through the slit into your peritoneal cavity. You’ll receive general or local anesthesia, and you may need to stay overnight in the hospital. However, most people can go home after the procedure.