Peritoneal Dialysis
How peritoneal dialysis works
Peritoneal dialysis uses the lining inside your abdomen, called the peritoneal membrane, as a natural filter. Dialysis fluid enters your abdomen through a soft tube called a catheter.
The fluid stays in your abdomen for a set time, where it helps remove waste products and extra fluid from your blood. It is then drained out and replaced with fresh fluid. This is called an exchange.
What is a peritoneal dialysis catheter?
A peritoneal dialysis catheter is a small, soft tube placed into your abdomen during a minor operation. Part of the tube stays outside your body so dialysis bags can be connected. The area where the tube leaves your body is called the exit site and needs daily care to help reduce the risk of infection.
Types of peritoneal dialysis
There are two main types of peritoneal dialysis. Your renal team will discuss which option may suit your health, lifestyle and home situation.
CAPD means continuous ambulatory peritoneal dialysis.
APD means automated peritoneal dialysis.
CAPD: With CAPD, dialysis fluid is usually changed around four times a day. Each exchange takes about 20 to 30 minutes. You will be taught how to use a clean technique, connect the bags safely, drain used fluid out, and run fresh fluid in.
APD: With APD, a machine carries out most of your exchanges overnight while you sleep. Some people may still need fluid in the abdomen during the day, or one daytime exchange, depending on their treatment plan.
Can I start straight away on the overnight machine?
Some people can start on APD, but you will usually also learn manual exchanges. This is important in case there is a power cut, machine problem, or another situation where you need to do an exchange without the machine. Your PD nurses will tailor training to your needs and preferences.
Starting peritoneal dialysis
If you choose peritoneal dialysis, the team will check that it is suitable for you. When dialysis is getting closer, you will have a date arranged for your PD catheter to be inserted in theatre. This may involve an overnight stay in hospital.
After the catheter is inserted, you will usually go home before starting dialysis. This gives the catheter and exit site time to heal. Supplies are ordered for your home and training is arranged.
A PD nurse will visit your home around 5 to 7 days after the catheter is inserted to show you how to look after the exit site. Training usually takes place at home around 2 weeks after catheter insertion and normally takes about 2 days. You will not be expected to do dialysis on your own until you feel confident.
Can I go on holiday?
Many people on peritoneal dialysis can travel, but planning ahead is important. For short trips, you may be able to take supplies with you. For longer trips, please speak to your PD nurses as early as possible, usually 2 to 3 months before travel, so fluid deliveries can be discussed. If you use APD, you will usually need to take the machine with you as medical equipment, or discuss using manual exchanges while away.
Possible advantages of peritoneal dialysis
Peritoneal dialysis may offer benefits for some people, including:
- More flexibility and time at home
- Less travel to hospital or dialysis units
- Fewer fluid or diet restrictions for some people
- Preserving vascular access options for the future
- More flexibility when planning holidays, with support from the PD team