Peritoneal Dialysis
Peritoneal dialysis (PD) is a type of dialysis used to treat end-stage kidney disease (ESKD) by removing waste products and excess fluid from the body. Unlike hemodialysis, which filters blood outside the body, peritoneal dialysis uses the peritoneum, a membrane lining the abdominal cavity, as a natural filter.
Types of Peritoneal Dialysis
There are two main types of peritoneal dialysis:
Continuous Ambulatory Peritoneal Dialysis (CAPD):
- Manual Process: Involves the manual exchange of dialysis fluid (dialysate) several times a day.
- No Machine Required: Patients can perform exchanges themselves, allowing for flexibility in their daily activities.
Automated Peritoneal Dialysis (APD):
- Mechanized Process: Uses a machine (cycler) to perform dialysate exchanges automatically during the night while the patient sleeps.
- More Frequent Exchanges: Typically involves multiple exchanges throughout the night, followed by a dwell period during the day.
Procedure
During peritoneal dialysis:
- Catheter Placement: A soft, flexible catheter is surgically placed into the abdomen to access the peritoneal cavity.
- Dialysate Exchange: Dialysate is infused into the peritoneal cavity through the catheter, allowing waste products and excess fluids to pass from the blood vessels in the peritoneum into the dialysate.
- Dwell Period: The dialysate remains in the abdomen for a prescribed dwell time, during which waste products and fluids are removed.
- Drainage: The used dialysate containing waste products is drained from the abdomen and discarded.
Advantages
- Flexibility: CAPD allows patients to perform exchanges independently, without being tied to a dialysis center.
- Continuous Treatment: APD provides continuous dialysis throughout the night, which can be beneficial for removing toxins and excess fluid more effectively.
Considerations
- Infection Risk: Careful hygiene and aseptic technique are essential to prevent peritonitis, a potentially serious complication.
- Nutritional Considerations: Dietary adjustments may be necessary to manage electrolyte imbalances and maintain nutritional status.
- Monitoring: Regular monitoring of blood pressure, fluid status, and kidney function is crucial to ensure effective treatment.
