Chronic Peritoneal Dialysis
What is it?
Chronic peritoneal dialysis is a procedure used to
treat kidney failure. A special fluid that removes waste
products is injected into the patient’s abdomen. After a
period of time, the fluid is drained out of the abdomen,
and replaced with fresh fluid. Chronic means this
procedure is performed on a regular basis.
Who needs this procedure?
People whose kidneys no longer function as they should
require peritoneal dialysis. Loss of kidney function can
be caused by disease, a traumatic injury, drugs or
poisons, or an obstruction of the urinary tract.
Peritoneal dialysis is more likely to be used with small
children and infants whose veins are not large enough to
support hemodialysis.
How do I prepare for this procedure?
Once the decision is made to begin peritoneal dialysis,
your doctor or a dialysis specialist will explain the
procedure to you. He or she will identify a site in your
abdomen where a flexible tube called a catheter will be
inserted to carry the fluid into the abdomen and drain it
back out again. This is called the access site. Your blood
pressure, temperature, and weight will be checked right
before each peritoneal dialysis treatment. Your “before”
weight will be compared with your weight after treatment
to make sure you are not retaining too much fluid.
How is this procedure performed?
Peritoneal dialysis sessions take place in a hospital’s
dialysis unit or an outpatient dialysis center. However,
with special training, this procedure can also be
performed in the home. Your doctor can discuss this option
with you. The peritoneum is a membrane that lines the
walls of the abdominal cavity. It is full of blood
vessels, so it can be used to help filter wastes. A
catheter is surgically inserted through the abdominal wall
and into the peritoneum. Then, a fluid called dialysate is
injected into the catheter. Dialysate is a chemical
solution that absorbs wastes and extra fluids and carries
them away from the blood. The dialysate is left in the
abdomen for a certain period of time, then drained out
through the catheter. Then, the catheter is injected with
fresh sterile dialysate that contains electrolytes and
other chemicals that your body needs to maintain in a
careful balance in order to function properly. There are
different types of peritoneal dialysis. Continuous
ambulatory peritoneal dialysis (CAPD) is administered by
the patient or a trained caregiver, who drains the
dialysate fluid and adds fresh fluid around four to five
times a day. Each time fresh dialysate is added through
the catheter, it is left in the abdomen for four to six
hours before being removed and replaced. The patient can
wear the bag of dialysate solution under his or her
clothes. Another type of peritoneal dialysis that also can
be performed at home is called continuous cyclic
peritoneal dialysis (CCPD). This type is performed by a
machine that automatically exchanges the waste-filled
dialysate with fresh dialysate while the patient sleeps at
night. The patient might then use CAPD during the day.
Intermittent peritoneal dialysis (IPD) is performed in a
hospital, usually several times a week. Like CCPD, a
machine automatically removes the waste-filled dialysate
and adds fresh dialysate.
What can I expect after the procedure?
Throughout your peritoneal dialysis treatments, your
blood will be tested regularly for levels of blood urea
nitrogen (BUN), which tells your doctors how well the
peritoneal dialysis process is filtering waste products
from your blood. Your doctor will explain how to keep your
access site clean to prevent infection, and how to detect
signs of infection. He or she will also provide you with
guidelines for your diet and prescribe medications to
treat your condition. It is especially important to
monitor your intake of fluids, sodium, and potassium,
following your doctor’s recommendations. Your doctor will
also recommend vitamin and mineral supplements to replace
those lost during treatment. Patients on peritoneal
dialysis lose protein during the treatment, so they need
to make sure their diets contain adequate amounts of
protein. Possible complications of peritoneal dialysis
treatment include loss of appetite, bleeding around the
access site, and infection. It is important to keep a
close eye on the area around the catheter and report any
signs of infection to your doctor. A serious infection of
the peritoneum, called peritonitis, causes flu-like
symptoms. Because peritoneal dialysis requires a
significant time commitment and has a great impact on
lifestyle, relationships, and activities, some patients
find they begin to feel depressed. It is important to seek
the support of family and professional counseling to
relieve these feelings and maintain your quality of life.
Self-care tips
If you are receiving peritoneal dialysis treatments,
follow your doctor’s diet, fluid intake, and medication
recommendations. Your doctor can suggest a registered
dietician who can help you find the right diet to meet
your needs.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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