Kidney Failure (cont.)
Peritoneal Dialysis
What is peritoneal dialysis?
Peritoneal dialysis is another procedure that replaces the
work of your kidneys. It removes extra water, wastes, and
chemicals from your body. This type of dialysis uses the
lining of your abdomen to filter your blood. This lining is
called the peritoneal membrane.
How does peritoneal dialysis work?
A cleansing solution, called dialysate, travels through a
special tube into your abdomen. Fluid, wastes, and
chemicals pass from tiny blood vessels in the peritoneal
membrane into the dialysate. After several hours, the
dialysate gets drained from your abdomen, taking the wastes
from your blood with it. Then you fill your abdomen with
fresh dialysate and the cleaning process begins again.
How do you get prepared for peritoneal dialysis?
Before your first treatment, a surgeon places a small, soft
tube called a catheter into your abdomen. This catheter
always stays there. It helps transport the dialysate to and
from your peritoneal membrane.
What are the types of peritoneal dialysis?
There are three types of peritoneal dialysis:
1. Continuous Ambulatory Peritoneal Dialysis (CAPD)
CAPD is the most common type of peritoneal dialysis. It
needs no machine. It can be done in any clean, well-lit
place. With CAPD, your blood is always being cleaned. The
dialysate passes from a plastic bag through the catheter
and into your abdomen. The dialysate stays in your abdomen
with the catheter sealed. After several hours, you drain
the solution back into the bag. Then you refill your
abdomen with fresh solution through the same catheter. Now
the cleaning process begins again.
2. Continuous Cyclic Peritoneal Dialysis (CCPD)
CCPD is like CAPD except that a machine, which connects to
your catheter, automatically fills and drains the dialysate
from your abdomen. The machine does this at night while you
sleep.
3. Intermittent Peritoneal Dialysis (IPD)
IPD uses the same type of machine as CCPD to add and drain
the dialysate. IPD can be done at home, but it's usually
done in the hospital. IPD treatments take longer than CCPD.
Who performs peritoneal dialysis?
CAPD is a form of self-treatment. It needs no machine and
no partner. However, with IPD and CCPD, you need a machine
and the help of a partner (family member, friend, or health
professional).
How long does peritoneal dialysis take?
With CAPD, the dialysate stays in your abdomen for about 4
to 6 hours. The process of draining the dialysate and
replacing fresh solution takes 30 to 40 minutes. Most
people change the solution four times a day.
With CCPD, treatments last from 10 to 12 hours every night.
With IPD, treatments are done several times a week, for a
total of 36 to 42 hours per week. Sessions may last up to
24 hours.
What are the possible complications of peritoneal dialysis?
Peritonitis, or infection of the peritoneum, can occur if
the opening where the catheter enters your body gets
infected. You can also get it if there is a problem
connecting or disconnecting the catheter from the bags.
Peritonitis can make you feel sick. It can cause a fever
and stomach pain.
To avoid peritonitis, you must be careful to follow the
procedure exactly. You must know the early signs of
peritonitis. Look for reddening or swelling around the
catheter. You should also note if your dialysate looks
cloudy. It is important to report these signs to your
doctor so that the peritonitis can be treated quickly to
avoid serious problems.
What type of diet is beneficial to peritoneal dialysis?
Diet for peritoneal dialysis is slightly different than
diet for hemodialysis.
- You may be able to have more salt and fluids.
- You may eat more protein.
- You may have different potassium restrictions.
- You may need to cut back on the number of calories you
eat. This limitation is because the sugar in the dialysate
may cause you to gain weight.
What are the pros and cons of each type of peritoneal dialysis?
CAPD Pros:
- You can perform treatment alone.
- You can do it at times you choose.
- You can do it in many locations.
- You don't need a machine.
CAPD Cons:
- It disrupts your daily schedule.
CCPD Pros:
- You can do it at night, mainly while you sleep.
CCPD Cons:
- You need a machine and help from a partner.
IPD Pros:
- Health professionals usually perform treatments.
IPD Cons:
- You may need to go to a hospital.
- It takes a lot of time.
- You need a machine.
Questions you may want to ask about peritoneal dialysis.
- Is peritoneal dialysis the best treatment choice for
me? Why or why not? Which type?
- How long will it take me to learn peritoneal dialysis?
- What does peritoneal dialysis feel like? Does it hurt?
- How will peritoneal dialysis affect my blood pressure?
- How do I know if I have peritonitis? How is peritonitis
treated?
- As a peritoneal dialysis patient, will I be able to
continue working?
- How much should I exercise?
- Who will be on my health care team? How can they help
me?
- Who can I talk with about sexuality, finances, or
family concerns?
- How/where can I talk to other people who have faced
this decision?
Dialysis is not a cure
Hemodialysis and peritoneal dialysis are treatments that
try to replace your failed kidneys. These treatments help
you feel better and live longer, but they are not cures for
ESRD. While patients with ESRD are now living longer than
ever, ESRD can cause problems over the years. Some problems
are bone disease, high blood pressure, nerve damage, and
anemia (having too few red blood cells). Although these
problems won't go away with dialysis, doctors now have new
and better ways to treat or prevent them. You should
discuss these treatments with your doctor.