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Peritoneal Dialysis

 

Peritoneal dialysis occurs inside the body. It uses your peritoneal membrane (the lining of your abdomen) as the filter. For this treatment, a tube called a catheter is surgically placed through the wall of your abdomen. Special dialysis solution will flow into the peritoneum through the catheter. Waste products and excess fluids pass from the blood. They move through the peritoneal membrane, into the dialysis solution. Then, they are drained from the peritoneal cavity. Peritoneal dialysis can be performed by hand or by using a machine. Tubing and bags are worn only during the solution exchange.

Continuous Ambulatory Peritoneal Dialysis (CAPD)

CAPD allows gravity to draw dialysis solution in and out of the peritoneal cavity, using system of tubing and bags. With CAPD, you connect tubing and a bag of sterile dialysis solution to the peritoneal catheter. By raising the bag to shoulder level or higher, the solution flows into the peritoneum. When empty, simply remove and throw away the tubing and solution bag.

During daily activities, the peritoneal membrane acts as a filter for your blood. Waste products and excess water transfer to the dialysis solution. After a few hours, you attach new tubing and an empty bag to the catheter. Then, lower the bag to drain the waste-filled filled fluid from the peritoneum.

  • Connect the tubing set to the catheter
  • Drain out the used solution
  • Fill with the new solution
  • Disconnect the tubing set from the catheter
  • Throw away the used solution, disposable tubing and bags.

The number of exchanges per day and length of time per exchange varies by person to person. Usually, CAPD is performed four times a day. Each solution exchanges last about half an hour. Assistants help people with problems using their hands to do CAPD.

Automated Peritoneal Dialysis (APD)

The second type of peritoneal dialysis, automated peritoneal dialysis (APD) involves a machine. You attach the tubing and solution bags to the machine. Before going to sleep, you connect the tubing to the peritoneal catheter. During the night the machine performs the dialysis. For extra therapy, dialysis solution remains in the peritoneal cavity during the day. The peritoneal cavity of most adults can hold two to three liters of fluid.

The Advantages and Disadvantages of Peritoneal Dialysis

Advantages:

  1. Patient very involved in self-care
  2. Control over schedule/freedom
  3. Less restricted diet
  4. Typically, once a month clinic visits
  5. No needles
  6. More steady physical condition
  7. Typically, no daytime exchange (APD)

Disadvantages:

  1. Four exchanges per day
  2. Nightly machine exchange (APD)
  3. Permanent external catheter.
  4. Some risk of infections
  5. Potential weight gain
  6. Store supplies at home
  7. Body image change

We conduct PD Catheter insertion, CAPD counseling and training.

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