Services

Mercy Dialysis Center

What is Peritoneal Dialysis?

Peritoneal dialysis is a type of dialysis that works inside your body. It uses the body’s own peritoneum to replace the filtering action of your kidneys. The peritoneum is a thin plastic-like membrane inside the belly that surrounds all the abdominal organs, such as the intestines and stomach. It is semi-permeable, meaning it only allows certain things to pass through it from the blood stream.

How Does Peritoneal Dialysis Work?

Peritoneal DialysisA tube called a catheter is surgically placed through the abdominal wall into the peritoneal cavity. A special solution (it looks like water) called dialysate flows through this catheter into the abdomen where waste products and fluid filter from the blood stream into the dialysate, which is then drained out again and discarded. This process, which is not painful, is called an exchange.

There are two main ways this can be done and in both instances the patient and family member are carefully trained to feel confident doing this at home. With either method, tubing and bags are connected only during the exchange and supplies are disposable.

One method, called “continuous ambulatory peritoneal dialysis” is done manually at intervals during the day. Each exchange usually takes less than one half hour. The number of exchanges per day varies by person but is frequently four per day.

Another method, called “continuous cycling peritoneal dialysis” is done with the use of a small portable machine and is generally performed at night. Again, the time required varies by person.

The key word with both methods is “continuous,” meaning dialysis is occurring continuously while walking, sitting, working, playing, eating or sleeping, even when no bags or tubing are connected.

The Exchange Steps

An exchange consists of three steps.

  1. Drain. This means letting the dialysate fluid, which is inside your peritoneum drain out through your catheter. The fluid has been in your peritoneal cavity, cleaning your blood, for about four to six hours. To let this fluid out of your body, you attach a long thin tube and open a clamp. The fluid, which now is filled with waste products and extra water, drains by gravity into an empty bag which you put on a clean surface below you. Draining normally takes about 20 minutes. You can be reading, watching TV, or resting while you are draining.
  2. Fill. This means letting new fresh fluid fill up your peritoneum. First, you will attach a new bag of dialysate, and hang it higher than your head. You can use a hook on a wall or an IV pole. Then you open a clamp on another long thin tube and the fluid runs through the catheter and into your peritoneum. This also works by gravity and takes about ten minutes. Your nurse will show you exactly how to do this. After you have filled, you just go on with your normal daily activities.
  3. Dwell. This means letting the fluid stay inside your body, inside your peritoneum, continuously cleaning your blood. It is during this dwell time that the dialysis is working. You will have fluid dwelling in your peritoneum for about four to six hours before you do another exchange and put fresh solution into your peritoneum. At first, you may notice the fluid inside. After you’ve been doing peritoneal dialysis for a few days, you won’t notice it at all.

Which Patients are Candidates for Peritoneal Dialysis?

A wide variety of patients can benefit from peritoneal dialysis.

  • Those wanting a lifestyle with more freedom (e.g. those who travel, are retired, have busy work/home schedules, or attend school)
  • Those with diabetes, cardiovascular disease, or hypertension.
  • Patients who live a long way from their dialysis unit and/or who have had problems with hemodialysis.
  • Individuals whose peritoneal membrane can handle the daily needs of this option.

These are advantages and disadvantages to peritoneal dialysis.

Advantages

  • Patient very involved in self-care
  • Control over schedule/freedom
  • Less restricted diet
  • Typically, once a month clinic visits
  • No needles
  • More steady physical condition
  • Typically, no daytime exchanged (APD)

Disadvantages

  • Requires patient to be responsible to do daily
  • Permanent external catheter
  • Some risk of infections
  • Potential weight gain
  • Store supplies at home
  • Body image change

Problem Guide for Peritoneal Dialysis Patients

Mercy Dialysis Center logo