Peritoneal dialysis (PD) is a treatment for people who have kidney failure. Kidney failure is stage five of chronic kidney disease (CKD). Healthy kidneys clean wastes from blood and remove extra fluid from the body. But when your kidneys are not working well, wastes and extra fluid can build up in your blood and make you sick. This can cause:
- trouble sleeping
- poor appetite
- loss of energy
- dry, itchy skin
- weight loss
- irregular menstrual periods
- muscle cramping, especially at night
- anemia (low blood count)
- trouble breathing
Why do I need peritoneal dialysis?
You need treatment because your kidneys no longer clean enough wastes from your blood and remove extra fluid from your body. Even though people with kidney failure may still have some kidney function, it’s not enough and without treatment you will die.
How does peritoneal dialysis work?
A soft tube, called a catheter, is placed in your belly. This is done by minor surgery. This catheter makes it possible for you to easily connect to a special tubing which allows two to three quarts of a cleansing fluid to flow into your belly. The cleansing fluid is called dialysate. It takes about 10 minutes for the dialysate to fill your belly. When the filling is done, the catheter is capped so that it doesn’t leak.
What happens next is an amazing process. The lining of your belly (called the peritoneal membrane) acts as a natural filter. It lets the wastes and extra fluid in your blood pass through it into the cleansing fluid. At the same time, the lining of your belly holds back the important things your body needs, like red blood cells and nutrients. To do its job, the dialysate must stay in your belly for two hours or more, depending on your body size and how much waste has to be removed. This time is called your dwell time. After your dwell time, you drain the cleansing fluid from your body into an empty bag. You discard the bag. You then repeat the in-and-out process a number of times during the day, using fresh dialysate. The process of exchanging bags of dialysate is called a bag exchange. PD can be done at home, at work, or while traveling.
Are there different types of peritoneal dialysis?
Yes. The major ones are:
Continuous Ambulatory Peritoneal Dialysis (CAPD). With CAPD, you do the exchanges yourself three to four times a day.
Continuous Cycling Peritoneal Dialysis (CCPD). With CCPD, a machine called a cycler does the exchanges automatically while you sleep. You may also need to do one exchange during the day if your kidney function decreases further.
How will I know how much dialysis I need?
The amount of dialysis needed is different for everyone. It is based on many factors, including your weight, how much kidney function you still have, your overall health, and the results of your lab tests. Your doctor will give you a dialysis prescription that is designed just for you. Your prescription will tell you:
- How many exchanges you need to make each day.
- How long the dialysis fluid needs to stay in your belly (your dwell time).
- What type and amount of dialysis fluid you need to use for each exchange.