What is peritoneal dialysis?
Peritoneal dialysis is a treatment for kidney failure. It uses the lining of your abdomen, or tummy, to filter your blood inside your body. This filtering will remove waste products that have built up in your blood stream. Health care professionals call this lining the peritoneum.
How does PD work?
When you have peritoneal dialysis, a specially manufactured fluid containing water with salts and other additives flows from a bag into your abdomen. Whilst the dialysis fluid is inside your tummy, it absorbs wastes and extra fluid from the body. The dialysis fluid is then drained out of your body, taking with it the toxins and excess water. This process is called an exchange.
A few weeks before starting the treatment, you will have a soft tube, called a catheter, placed into your abdomen. This stays in your abdomen all the time, with part of the catheter on the outside of your body.
You can do your exchanges during the day, or at night. There are many ways to do this.
Types of PD:
Continuous ambulatory peritoneal dialysis (CAPD):
If you choose this type of dialysis, you can perform the exchanges several times during the day. The dialysis solution will flow in and once the bag is empty, you disconnect it and place a cap on the catheter. As you are doing your normal activities, the solution inside your tummy will absorb waste and extra fluid from your body. After a few hours, the solution which now has waste products, is drained out of your tummy into an empty bag. Then, you repeat the process with a fresh bag of dialysis solution. Each treatment takes about 30 to 40 minutes and you will usually need to repeat this four to six times a day.
Automated peritoneal dialysis (APD) :
This can be done by a machine overnight while you sleep. You need to set-up the machine before you go to bed. The dialysis fluid is flushed into your tummy and taken out automatically by the machine overnight. Usually the machine will fill and empty your tummy three to five times during the night. Sometimes you may need to change the fluid in your tummy once in the middle of day. The way that you perform PD will depend on what suits your lifestyle and what you require in terms of waste product and fluid removal.
Preparation for PD:
It is important that there is an area at home which will be cool, clean and dry to store your dialysis supplies. You will need to have a clean, dry and well-lit space to perform your exchanges and you will to have easy access to a sink to wash your hands. You will need to have a small operation to insert the catheter into your abdomen. Some units can do this under local anaesthetic or you may need a general anaesthetic, especially if you have had operations on your tummy before. After the operation, you will usually need to wait 2 weeks to recover. Your kidney team will then train you to perform PD. You may need to make changes to your schedule to fit your dialysis treatment into your daily routine. If you do exchanges during the day, you will need to stop your normal day to day activities for about 30 minutes to perform an exchange. If you do automated peritoneal dialysis, you will need to set up the dialysis machine every night.
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