5 Common Questions About Peritoneal Dialysis

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What is peritoneal dialysis for?

Peritoneal dialysis is another procedure that removes waste, chemicals, and extra water from your body. This type of dialysis uses a layer of your stomach, or stomach, to filter your blood. this layer is called the peritoneal membrane and acts as an artificial kidney.

How does peritoneal dialysis work?

A mixture of minerals and sugar dissolved in water, called dialysis fluid, flows through the catheter into your stomach. Sugar (called dextrose) attracts waste, chemicals, and extra water from small blood vessels in your peritoneal membrane into dialysis solutions. After a few hours, the solution used is drained from your stomach through a tube, which carries waste from your blood with the liquid. Then your stomach is refilled with fresh dialysis fluid, and the cycle is repeated. The process of drying and refilling is called exchange.

What are the types of peritoneal dialysis?

Three types of peritoneal dialysis are available.

Continious Ambulatory Peritoneal Dialysis (CAPD)

CAPD does not require a machine and can be done in a clean, dimly lit room. With CAPD, your blood is always cleansed. Dialysis solutions are flowed from a plastic bag through a catheter and into your stomach, where the fluid stays for several hours with a sealed catheter. The time period in which dialysis fluid is in your stomach is called residence time. Next, you dry the dialysis liquid into an empty bag for disposal. You then fill your stomach with fresh dialysis fluid so that the cleaning process can begin again. With CAPD, dialysis solution stays in your stomach for a stay of 4 to 6 hours, or more. The drying process of dialysis fluid used and replacing it with fresh solution takes about 30 to 40 minutes. Most people change dialysis fluids at least four times a day and sleep with a solution in their stomach at night. With CAPD, there is no need to get up and do dialysis tasks at night.

Continius Cycler-assisted Peritoneal Dialysis (CCPD)

CCPD uses a machine called a cycler to fill and empty the stomach three to five times during the night when you sleep. In the morning, you start one exchange with a stay that lasts all day. You can make additional exchanges in the middle of the afternoon without a cycler to increase the amount of waste disposed and to reduce the amount of fluid left in your body.

Combination of CAPD and CCPD

If you weigh more than 80 kg or if your peritoneum filters waste slowly, you may need a combination of CAPD and CCPD to get the right dialysis dose. For example, some people use cyclers at night but also make one exchange during the day. Others do four exchanges during the day and use a minicycler to do one or more exchanges at night. You will work with your health care team to determine the best schedule for you.

Are diet changes needed?

Dietary peritoneal dialysis is slightly different from the central hemodialysis diet.

  • You still need to limit salt and fluids, but you may need more than each of these substances, compared with hemodialysis at the center.
  • You have to eat more protein.
  • You may have different limits on potassium. You might even need to eat high-potassium foods.
  • You may need to reduce the number of calories you eat because there are calories in dialysis fluid that can cause you to gain weight.

Doctors and nutritionists who specialize in helping people with kidney failure will be able to help you plan your food.

What are the pros and cons of peritoneal dialysis?

Each type of peritoneal dialysis has advantages and disadvantages.

CAPD

Pro:

  • You can do it yourself.
  • You can do it at the time you choose as long as you make the number of exchanges needed every day.
  • You can do it in many locations.
  • You don't need a machine.
  • You will not have the feeling that many hemodialysis patients feel.
  • You do not need to travel to the hospital three times a week.

Counter:

  • This can interfere with your daily schedule.
  • This is a continuous treatment, and all exchanges must be done 7 days a week.

CCPD

Pro:

  • You can do it at night, especially when you sleep.
  • You are free to exchange during the day.

Counter:

  • You need a machine.
  • Your movement at night is limited by your connection to the cycler of the engine.

What should I remember?

Dialysis hemodialysis and peritoneal dialysis are treatments that help replace your kidney work. This treatment helps you feel better and live longer, but they do not cure kidney failure. Although patients with kidney failure now live longer than before, kidney disease that occurs for years can cause problems such as heart disease, bone disease, arthritis, nerve damage, infertility, and malnutrition.

These problems will not go with dialysis, but doctors now have new and better ways to prevent or treat them. You should discuss these complications and their care with your doctor.

5 Common Questions About Peritoneal Dialysis
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