Peritoneal dialysis (PD) is performed daily by filling the abdomen with a special solution, waiting for a period of time, and then draining the solution. This form of dialysis can be performed at home or work. Just like hemodialysis, peritoneal dialysis uses a filter to clean the blood and remove excess fluids. However, the blood is cleansed inside your body using the peritoneal membrane in the abdomen as the filter.
There are two types of peritoneal dialysis: Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cycling Peritoneal Dialysis.
Continuous ambulatory peritoneal dialysis (CAPD)
This form for PD is performed manually by the patient and includes four or five "exchanges" per day. During each exchange, the peritoneal cavity is filled with dialysate fluid. The fluid is then drained via gravity and the abdomen is refilled. Exchanges are performed prior to breakfast, lunch, dinner and bedtime. An exchange consists of a 15 to 20 minute drain, and a 10 to 20 minute fill. This requires up to two hours per day. The rest of the time the fluid is residing inside your abdomen and you can go about your daily routine.
During PD treatments, a cleansing fluid called dialysate is put into the patient's abdomen through a small, flexible tube called a PD catheter. Once extra fluid and substances move across the membrane, the dialysate is drained and replaced with fresh dialysate. Surgery is required for the placement of the catheter in the peritoneal cavity requiring two to six weeks of healing time.
PD may be performed at home, and requires training for both the patient and his/her family. PD can also be completed overnight, either manually (CAPD) or on a cycler machine (CCPD).
Continuous cycling peritoneal dialysis (CCPD)
This form of PD is performed by attaching your abdominal catheter to a small, portable machine called a cycler. It automates the filling and draining process while you sleep, and typically consists of four to five exchanges over the course of a night. CCPD requires a minimum of eight hours each night. CCPD allows for more freedom during the day for work or activities. It requires training in a dialysis clinic and, in some cases, your physician may require you to complete an additional manual exchange during the day.
Training and Visits
Training for PD takes place at your local dialysis clinic or doctor's office. It can last one to two weeks and require several hours each day. During PD training you will learn how to perform an exchange, how to care for your access, and how to look for the signs and symptoms of complications.
Once you are trained and performing PD at home you will visit your clinic at least twice per month. You and your dialysis team will review lab reports, medications, the overall treatment plan, and address any of your concerns.