What is Peritoneal Dialysis?

Peritoneal dialysis is a type of dialysis that takes over the job of your kidneys when they aren't working well or have completely failed. Your kidneys are part of your urinary system. Their main function is to filter waste products and extra water from your blood, turning it into urine. When your kidneys can't do this, these waste products, called toxins, build up in your blood, a condition known as uremia. This eventually leads to kidney failure, which can be fatal if not treated.

Peritoneal dialysis uses the natural membrane lining your abdomen, called the peritoneum, as a filter to remove toxins, waste, and excess water from your body. A doctor or another healthcare professional will insert a soft tube, or catheter, into your body through a small procedure. This tube puts a special cleansing fluid called dialysate into your abdomen. The fluid stays in your belly for a few hours, during which your peritoneum filters out waste and extra water from your blood and into the dialysate.

Once the process is complete, the fluid is drained out, taking the waste products with it. You then put in new fluid to start the process all over again. You can do this at home, either several times a day or at night while you sleep. This is often more convenient than other forms of dialysis.

What does peritoneal dialysis treat?

Peritoneal dialysis is used to treat kidney (renal) failure.

What are the types of peritoneal dialysis?

There are two main types of peritoneal dialysis:

Continuous ambulatory peritoneal dialysis (CAPD): This home-based option doesn't require a machine. With CAPD, you hang a bag of dialysis fluid from the catheter and hold the bag over your shoulder. Gravity helps the fluid flow into your abdomen. After about 30 minutes, you drain the fluid out. You need to do three to five CAPD exchanges every day. You can do an exchange anywhere that is clean, dry, and well-lit. You are free to go about your normal activities while the cleansing fluid is inside your body.
Automated peritoneal dialysis (APD): APD uses a machine called an automated cycler that automatically puts the dialysis solution into your belly and drains it back out. The cycler performs three to five exchanges per session. Most people prefer to do APD at night while they sleep. Another name for APD is continuous cycling peritoneal dialysis (CCPD).

Intermittent peritoneal dialysis (ipd) is a less common form of peritoneal dialysis. It uses the same automated cycler as APD, but the treatments last longer. Medical professionals typically perform IPD in a hospital setting.

How common is peritoneal dialysis?

Peritoneal dialysis is the least common type of dialysis. Only about 10% of people who need dialysis use peritoneal dialysis.

How should I prepare for peritoneal dialysis?

About a few weeks before you begin peritoneal dialysis, a doctor will surgically place a permanent catheter under your skin, usually near your belly button. This is a simple procedure. The doctor will also teach you how to:

Use the peritoneal dialysis equipment.
Attach the dialysis solution bags.
Care for the catheter site to prevent infection. Once the surgical site has healed, you can begin peritoneal dialysis.

What happens during peritoneal dialysis?

What you do depends on the type of peritoneal dialysis you're on. Before any session, it's important to wash your hands thoroughly with soap and water. It's also recommended that you use hand sanitizer and wear a face mask. These precautions help lower your risk of infection.

For Continuous Ambulatory Peritoneal Dialysis (CAPD):

Connect the catheter to one side of a Y-shaped tube. The tube is attached to the dialysis solution bag, which will then flow into your abdomen.
Hang the bag of dialysis solution over a pole held above your shoulder. Gravity will cause the solution to flow into your abdomen.
After the bag is empty, detach the tube and catheter. This process takes about 10 minutes.
Cover the catheter with a cap.
You can now resume your normal activities. A healthcare professional will advise you on what exercises are safe to do while on CAPD.
About 60 to 90 minutes later, connect an empty, clean bag to the other leg of the Y-shaped tube and remove the catheter cap. Drain the dialysis fluid from your abdomen into the bag.
You should repeat this process three to five times a day, as instructed by your doctor.

For Automated Peritoneal Dialysis (APD):

Clean the automated cycler machine.
Prepare the dialysis fluid.
Attach the tubing to the cycler.
Clamp the tubes.
Attach the drainage bag and turn the machine on.
Secure the tubing to your catheter.
Start the machine.
Most people find it best to do APD at night. The machine adds and removes the dialysis solution about six times over an eight-hour period. In the morning, you disconnect the tubing from the machine, cap your catheter, and throw away the drainage bag. Then, you can continue with your daily routine.

Do I need to keep a record during peritoneal dialysis?

A healthcare professional may suggest that you keep track of certain information in a logbook each time you perform peritoneal dialysis, such as:

Your weight before you drain the fluid.
Your temperature.
Your blood pressure.
The type and amount of dialysis solution used.
How long it takes for the fluid to drain from your abdomen.
Your weight after draining the fluid.

How long does peritoneal dialysis last?

A single Continuous Ambulatory Peritoneal Dialysis (CAPD) session usually takes about 40 minutes. You need to do three to five sessions per day.

An Automated Peritoneal Dialysis (APD) session typically lasts eight to 12 hours. Most people prefer to do APD at night while they sleep.

What happens after peritoneal dialysis?

After the dialysis session, you disconnect the drainage bag and clean the catheter access site. Then, you can resume your normal activities.

Is peritoneal dialysis painful?

No, peritoneal dialysis is not painful. You might feel a bit of discomfort or a full feeling when the dialysis solution is in your belly.

What are the advantages of peritoneal dialysis?

The most significant benefit of peritoneal dialysis is that it removes waste products and extra water from your blood when your kidneys can no longer. Without dialysis or a kidney transplant, kidney failure is life-threatening.

Other benefits of peritoneal dialysis include:

Convenience: Unlike hemodialysis, you don't have to travel to a special clinic for treatment. You can perform peritoneal dialysis at home, work, traveling, or in any other clean environment.
Fewer dietary restrictions: Since you do peritoneal dialysis every day, fewer toxins and fluids build up in your body. This means you don't have to limit foods high in potassium, phosphorus, or sodium, or restrict your fluid intake as much as with hemodialysis. Having more control over your fluid balance can also reduce stress on your heart and blood vessels.
No needles: Before you start peritoneal dialysis, a catheter is surgically placed in your abdomen, which is then used to add and drain the solution. Hemodialysis requires needles, which can be uncomfortable or even frightening for people who have a fear of needles (trypanophobia).

What are the disadvantages of peritoneal dialysis?

Some people consider the main disadvantages of peritoneal dialysis to be:

You have to do it every day.
You have a permanent catheter in your stomach.
It may not be an option if you have had previous abdominal surgeries or if you are overweight (a BMI of 25 or higher).

Other risks and complications of peritoneal dialysis include:

Peritonitis: This is a bacterial infection that causes inflammation of the lining of your abdomen. Peritonitis is most common during the first two years of peritoneal dialysis.
Hernia: The extra pressure in your abdomen can lead to the formation of a hernia.
Scarring of the peritoneum: Scar tissue can prevent fluids and waste materials from moving through your peritoneum properly.
Malnutrition: Your body may not be able to absorb enough nutrients from your food. To ensure you're getting the right amounts of calories, vitamins, minerals, and protein, see a dietitian who specialises in kidney health (renal dietitian).
Weight gain: The dialysate fluid contains sugar (dextrose). If your body absorbs some of this fluid, you could be taking in hundreds of extra calories each day.
Ultrafiltration failure: Ultrafiltration is the process of using pressure to remove excess fluid from your blood. Ultrafiltration failure occurs when not enough fluid is able to cross through the peritoneum.
Catheter problems: The catheter can become blocked or fatty tissue in your belly (omentum) can wrap around the catheter (omental wrapping), which might clog the catheter or move it out of place.
Treatment becomes less effective: After a few years, peritoneal dialysis may no longer work well. In this case, you may need to switch to hemodialysis.

In some cases, doctors are not as familiar with peritoneal dialysis as they are with hemodialysis. They might be less likely to recommend peritoneal dialysis unless they have received the proper education and training.

Do I need to avoid anything while on peritoneal dialysis?

If you are on peritoneal dialysis, you should avoid:

Certain medications that can harm your kidneys, such as nonsteroidal anti-inflammatory drugs (NSAIDs).
Spending a lot of time in the water, such as soaking in a hot tub or bath, or swimming in lakes, ponds, rivers, or unchlorinated swimming pools.

Spending long periods in water puts you at risk of infection. Daily showers are safe. You can also swim in a chlorinated pool once your catheter exit site has completely healed. Always make sure to dry the area and put on dry clothes immediately after swimming or showering.

How long can a person be on peritoneal dialysis?

The average survival time after starting peritoneal dialysis is 5 to 10 years. However, some people have lived on dialysis for as long as 30 years without a significant decrease in their quality of life.

How long does recovery take?

It takes about two to three weeks to recover from the catheter surgery.

Once on peritoneal dialysis, some people feel relief from their kidney failure within a week, while others may take months to start feeling better. You should discuss what to expect with a medical provider.

When can I go back to work or school?

Many people are able to return to work or school while on peritoneal dialysis. You can do automated peritoneal dialysis at night, so you don't have to worry about it during the day. As long as you can find a clean place, you can also do continuous ambulatory peritoneal dialysis at work or school.

When should I call a doctor?

You should call a healthcare provider if you experience:

Abdominal pain or swelling.
Fever.
A rapid heart rate (tachycardia).
Shortness of breath (dyspnea).
Nausea and vomiting.
Difficulty urinating.
Symptoms of low blood pressure (hypotension), such as dizziness, fainting, or dehydration.

It's also a good idea to call a doctor if the dialysis solution looks cloudy or has an unusual color after you drain it from your abdomen.

Why choose Tender Palm Super Speciality Hospital for Peritoneal Dialysis in Lucknow, India?

Tender Palm Super-Speciality Hospital is one of the best hospitals for Peritoneal Dialysis in Lucknow, India. Our experienced Nephrologists uses advanced technology, and provides patient-focused care, the hospital ensures safer procedures, quicker recovery, and improved long-term outcomes.