What is it?
Peritoneal dialysis is a different method of dialysis that uses the inner lining of your abdomen to filter your blood. The most common type is called CAPD, or continuous ambulatory peritoneal dialysis.
How is it done?
A surgeon places a small catheter in your abdomen that stays there permanently. The abdominal cavity is quite big and the lining is called the peritoneal membrane. This membrane contains a big amount of small blood vessels. The catheter is connected to a special cleansing solution, dialysate, via a tube. The solution passes from a sterile plastic bag through the tube and into your abdomen. The dialysate (usually about 2 litres) stays in your peritoneal cavity with the catheter sealed. Due to chemical gradients, fluid, wastes and chemicals pass from the blood vessels to the solution. No machine is needed and you can be trained to do it yourself at home.
How long does it take?
It is a continuous process and after several hours the dialysate is drained from your abdomen taking the wastes and fluid with. The abdomen is then filled with fresh dialysate and the process starts all over again. Most people change the solution four times a day. Changing the dialysate takes about 20 to 30 minutes at a time and it can disrupt your daily schedule initially.
Infection of the peritoneum or the catheter insertion site can occur. Peritonitis can cause fever and stomach pains and must be reported immediately. Be sure to follow the correct procedure and look for warning signs like swelling or reddening around the catheter. The dialysate should not be cloudy.
The advice of your dietician is important. You may have different restrictions than patients on hemodialysis. The sugar content in the dialysate may cause weight gain and you will have to watch your calorie intake.
Written by Dr K. Coetzee, reviewed by Dr R. Moosa, head of the Renal Unit, Tygerberg Academic Hospital.
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