Peritoneal dialysis is a treatment where the peritoneal membrane (lining around the inside of your abdominal wall and the outside of your intestines) is used to filter and cleanse the impurities, waste products and extra fluid from your body. Peritoneal dialysis uses a fluid called dialysate to gently remove fluid and waste products from your abdominal cavity and place them in the dialysate. The dialysate fluid acts like a magnet that attracts waste and excess fluid from the body.
Peritoneal dialysis uses a catheter that is surgically or radiologically put into the abdominal cavity but outside the intestines and attached to the bag of dialysate solution for the treatment. After the treatment, the catheter is disconnected from the bag of dialysate and covered to keep it clean. You do not walk around with a bag stuck to your tummy.
You or your partner, in the comfort of your own home, perform the treatment. The treatment can be done safely in other locations so that you have the most flexible treatment arrangement. You can do the procedure at work or at school as well.
When your physician decides that your catheter is ready to use, training sessions will be arranged to teach you the best and safest way to perform dialysis. Trained dialysis staff will work with you to make your dialysis therapy and transition to independence as easy as possible. Trained staff are available to you on-call every day for emergencies if you have difficulty with your treatment at home.
The types of peritoneal dialysis are:
- Continuous ambulatory peritoneal dialysis (CAPD):
CAPD is done four times during the day. A set amount of fluid is placed into the abdominal cavity through your catheter. This fluid remains in the abdominal cavity for several hours and is then drained. The process is repeated 4 times daily. Each exchange takes about 30-40 minutes. The exchange schedule can be flexible to meet your needs. No machine is used for this type of treatment. YOU are in control.
- Automated peritoneal dialysis (APD):
APD is done at night using a machine called a cycler. The system automatically does the exchanges for you while you are sleeping. Most consumers must spend 8 to 10 hours every night to complete this process. It usually makes daytime manual exchanges unnecessary.
Peritoneal dialysis must be done every day. During your training, you are taught to follow specific procedures that allow you more freedom than on haemodialysis. It is a commitment that can be easy to follow. With encouragement from your family and healthcare team your lifestyle will require only minimal adaptation.
One of the major advantages of CAPD/APD is that it closely mimics the way the kidneys work naturally. Whereas haemodialysis removes waste products and water from your body 3 times per week in just a few hours, CAPD/APD does this constantly i.e. much like healthy kidneys do. It is for this reason that CAPD is often the preferred method for patients with heart disease.