What is peritoneal dialysis and how does it work?
Peritoneal Dialysis (PD) is a type of Dialysis done at home to remove excess waste and fluid when your kidney can no longer do the job adequately. This section of the website discusses facts related to PD as well as questions that patients commonly ask about PD.
Dialysis is a special procedure that can be used by people whose kidneys are no longer able to perform their function effectively. The idea behind dialysis of any kind is to cleanse the blood of waste products and toxins, as well as removing excess fluid, the way a normal kidney would.
To perform peritoneal dialysis, a patient must first have a catheter placed in their abdomen to allow the fluid to enter and drain. The catheter is placed by a surgeon in the abdomen and remains in place permanently while you are on peritoneal dialysis. To prevent entangling and interference with everyday activities like work, exercise, sexual activity, showering and recreation, catheter is taped down on the outside of the body or secured by a special belt.
Peritoneal Dialysis utilizes the inner lining of your abdominal or peritoneal cavity as a filter to remove excess fluid and waste products. A special fluid is introduced into the peritoneal cavity through the catheter and allowed stay in there for a period of time called dwell time. It is then drained out and a fresh dialysate instilled so that the process of removing toxins and excess water can be repeated. This process is called an exchange. Typically 4-5 exchanges maybe performed daily.
This process can be performed manually by use of gravity to infuse the dialysate in the peritoneal cavity or by automated machine called cycler to do the same process. Manual dialysis also called CAPD requires active involvement of the patient to fill and drain the fluid. Typically 4-5 cycles are performed with each cycles lasting about 4 hours. Using the cycler called APD has minimal involvement is is usually performed at night while sleeping. The cycler is programmed to perform the exchanges while you sleep.
Who can benefit from PD?
PD may be a choice for you under the following circumstances and/or conditions:
- Preference for independence and control
- Employed, full time or part-time
- Desire to travel and flexibility
- Fear of needles
- Awaiting kidney transplant
- Distance from the clinic
- Poorly controlled BP
- Heart diseases
- Children, young age
Patients who would not benefit from PD:
Certain conditions do not allow safe and effective PD. Below are some examples of conditions and situations which may not be possible to perform PD.
- Lack of storage space
- Poor personal hygiene
- Unhygienic home environments
- Multiple in-house pets
- Multiple abdominal surgeries
- Unstable mental disorders, memory disorders
- Uncontrolled psychosis
- Severe malnutrition
- Ongoing abdominal infections and abscess
- Advanced pregnancy
Lifestyle changes with PD:
Once you make the decision to do PD, you will need to make certain adjustments to your lifestyle and changes at home. These changes will help you streamline the PD process and reduce potential anxiety and stress associated with adapting to your new routine. Also, with any change, there is a transition period that is best seen as a learning process. Most patients soon understand what works best for them and plan their lives accordingly.
How has COVID-19 Impacted Dialysis Care? Dr. Rastogi explains the effect the pandemic has had on dialysis patients here.
Peritoneal Dialysis: A Patient's Experience
Peritoneal Dialysis: What You Should Know
Disclaimer: The UCLA Health System cannot guarantee the accuracy of such information. The information is provided without warranty or guarantee of any kind. Please speak to your Physician before making any changes.