Dialysis - peritoneal
Dialysis treats end-stage kidney failure. It removes harmful substances from the blood when the kidneys cannot.
This article focuses on peritoneal dialysis.
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Your kidneys' main job is to remove toxins and extra fluid from your blood. If waste products build up in your body, it can be dangerous and even cause death.
Kidney dialysis (peritoneal dialysis and other types of dialysis) does some of the job of the kidneys when they stop working well. This process:
WHAT IS PERITONEAL DIALYSIS?
Peritoneal dialysis (PD) removes waste and extra fluid through the blood vessels that line the walls of your abdomen. A membrane called the peritoneum covers the walls of your abdomen.
PD involves putting a soft, hollow tube (catheter) into your abdominal cavity and filling it with a cleansing fluid (dialysis solution). The solution contains a type of sugar that draws out waste and extra fluid. The waste and fluid passes from your blood vessels through the peritoneum and into the solution. After a set amount of time, the solution and waste is drained and thrown away.
The process of filling and draining your abdomen is called an exchange. The length of time the cleansing fluid remains in your body is called the dwell time. The number of exchanges and amount of dwell time depends on the method of PD you use and other factors.
Your doctor will perform surgery to place the catheter in your abdomen where it will stay. It is most often near your belly button.
PD may be a good option if you want more independence and are able to learn to treat yourself. You will have a lot to learn and need to be responsible for your care. You and your caregivers must learn how to:
With PD, it is important not to skip exchanges. Doing so can be dangerous to your health.
Some people feel more comfortable having a health care provider handle their treatment. You and your provider can decide what is best for you.
TYPES OF PERITONEAL DIALYSIS
PD gives you more flexibility because you do not have to go to a dialysis center. You can have treatments:
There are 2 types of PD:
The method you use depends on your:
You can also use some combination of the two methods. Your provider will help you find the method that works best for you.
Your provider will monitor you to make sure the exchanges are removing enough waste products. You will also be tested to see how much sugar your body absorbs from the cleansing fluid. Depending on the results, you may need to make certain adjustments:
WHEN TO START DIALYSIS
Kidney failure is the last stage of long-term (chronic) kidney disease. This is when your kidneys can no longer support your body's needs. Your doctor will discuss dialysis with you before you need it. In most cases, you will go on dialysis when you have only 10% to 15% of your kidney function left.
There is a risk for infection of the peritoneum (peritonitis) or the catheter site with PD. Your provider will show you how to clean and care for your catheter and prevent infection. Here are some tips:
Watch the exit site for swelling, bleeding, or signs of infection. Call your provider immediately if you have a fever or other signs of infection.
After the Procedure
Call your provider right away if you notice:
Also call your provider if you experience any of the following symptoms severely, or they last more than 2 days:
Cohen D, Valeri AM. Treatment of irreversible renal failure. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 131.
Correa-Rotter RC, Mehrota R, Saxena A. Peritoneal dialysis. In: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, Brenner BM, eds. Brenner and Rector's The Kidney. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 66.
Mitch WE. Chronic kidney disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 130.
Review Date: 10/15/2018
Reviewed By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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