Peritoneal dialysis (PD) is a treatment for kidney failure. A special sterile fluid is introduced into the abdomen through a permanent tube that is placed in the peritoneal cavity. The fluid circulates through abdomen to draw impurities from surrounding blood vessels in the peritoneum, which is then drained from the body.PD can be carried out at home, at work, or on trips, but requires careful supervision. PD gives patients more control. However, they need to work closely with the health care team including the nephrologist, dialysis nurse, dialysis technician, dietitian and social worker. The role of the PD patient and his/her family are very important. By learning more about the treatment, patients can work with the health care team to achieve the best possible results and lead an active life.
A PD catheter is inserted permanently at the abdomen to allow filling and draining of about two litres of PD solution into and out of the peritoneum or abdominal cavity, which is surrounded by the peritoneal membrane. The peritoneal membrane then filters waste and fluids from the blood into the solution.
The PD solution is allowed to remain in the abdomen for four to six hours before it is drained and replaced with fresh PD solution. The replacing of fresh PD solution with the used PD solution is called an exchange. Each exchange takes about 30 minutes. PD patients perform an average of four exchanges per day. Different types of PD have different schedules of daily exchanges.
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Unlike Haemodialysis, patients do not need a machine for CAPD. They need gravity to fill and empty their abdomen. The doctor will prescribe the number of exchanges a patient needs, typically three or four exchanges during the day and one evening exchange with a long overnight dwell time while one sleeps. As the word “ambulatory” suggests, the patient can walk around with the dialysis solution in the abdomen.
Automated Peritoneal Dialysis (APD)
An alternative to CAPD is Automated Peritoneal Dialysis (APD) where a machine called a cycler will change the dialysate solution during the night, usually while patients are asleep. This means that patients have to be attached to the machine for 8-10 hours.
Painless and No Needling
Gentler and works more like the natural kidney