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Patient education: Peritoneal dialysis (The Basics)

Patient education: Peritoneal dialysis (The Basics)

What is peritoneal dialysis? — Peritoneal dialysis is a treatment for kidney failure. Normally, the kidneys work to filter the blood and remove waste and excess salt and water (figure 1). Kidney failure, also called "end-stage kidney disease," is when the kidneys stop working completely.

Peritoneal dialysis is a procedure that involves piping a special fluid into the belly. This fluid collects waste and excess salt and water from the blood. Then the used fluid drains out of the belly.

Where will I do peritoneal dialysis? — You will do peritoneal dialysis at your home. You will need to do it every day.

When will I start peritoneal dialysis? — You and your doctor will decide the right time for you to start. It will depend partly on how well your kidneys work, and on your symptoms and overall health. Your doctor will do blood tests to check how well your kidneys are working.

Before you start peritoneal dialysis, you need surgery to create a way for the fluid to get in and out of your belly. The doctor will put a thin tube (called a "catheter") in your belly. One end of the tube stays in your belly. The other end stays outside your body. It takes about 2 weeks for your body to heal with the tube in it before you can start dialysis.

You will also need to learn how to do peritoneal dialysis. A nurse will teach you or a family member (if they will do it) how to set up and use the equipment.

What happens during peritoneal dialysis? — During peritoneal dialysis, you will hook up your belly tube to the dialysis tubing (figure 2). You will pipe clean fluid into your belly. The fluid will stay there for a certain amount of time. When the fluid is in your belly, it's called a "dwell." During a dwell, your belly might feel full or bloated, but it shouldn't hurt.

After the dwell, you will drain the used fluid out of your belly and throw it away. Then you will refill your belly with clean fluid. Each time you drain the used fluid and refill your belly with clean fluid, it's called an "exchange." It's important to follow all your doctor's instructions about each exchange and dwell.

How often will I do peritoneal dialysis and how long does it take? — Your schedule depends on the type of peritoneal dialysis you do. There are 2 types of peritoneal dialysis:

Continuous ambulatory peritoneal dialysis (CAPD) – CAPD is done all day and night. People do the exchanges themselves. People usually do 3 to 5 exchanges during the day and do a dwell overnight. Each daytime exchange takes about 30 to 40 minutes.

Continuous cycling peritoneal dialysis (CCPD) – For CCPD, a machine does the exchanges. CCPD is usually done overnight.

Most people can choose the type of peritoneal dialysis they have. Talk with your doctor about which type of peritoneal dialysis is best for you.

What problems can happen with peritoneal dialysis? — Problems that can happen with peritoneal dialysis include:

An infection of the skin around the tube – An infection can cause the skin to become red, painful, or hard. Pus might also drain from the area. Treatment usually includes antibiotic medicines or creams.

An infection inside the belly (called "peritonitis") – Peritonitis can cause belly pain, fever, nausea, or diarrhea. It can also cause the used fluid to look cloudy. Treatment usually includes antibiotics that go into the belly with the dialysis fluid.

A hernia – A hernia is when a belly muscle becomes weak. It causes an area of the belly to bulge out. It usually doesn't hurt. A hernia is treated with surgery.

Call your doctor or nurse if:

The skin around your tube gets red, painful, or hard, or pus drains from it.

You have belly pain, fever, or the used dialysis fluid looks cloudy.

A part of your belly bulges out.

Is there anything else I should do? — Yes, you will need to:

Weigh yourself every day – You need to use your weight to figure out each day's dialysis treatment.

Take care of the skin around your tube – Every 1 to 2 days, wash the area carefully, pat it dry, and put an antibiotic cream on it. Keep the area covered with gauze and tape. Tell your doctor or nurse if you injure the area or if the tube moves out of place.

Follow a special diet – You might need to limit the amount of fluids you drink and eat. You might also need to avoid foods with a lot of sodium, potassium, and phosphorous. These are minerals that can build up in your body if you have kidney problems.

More on this topic

Patient education: Chronic kidney disease (The Basics)
Patient education: Choosing between dialysis and kidney transplant (The Basics)
Patient education: Dialysis and diet (The Basics)
Patient education: Low-sodium diet (The Basics)
Patient education: Hemodialysis (The Basics)
Patient education: Low-potassium diet (The Basics)
Patient education: Acute kidney injury (The Basics)

Patient education: Peritoneal dialysis (Beyond the Basics)
Patient education: Chronic kidney disease (Beyond the Basics)
Patient education: Dialysis or kidney transplantation — which is right for me? (Beyond the Basics)
Patient education: Low-sodium diet (Beyond the Basics)
Patient education: Low-potassium diet (Beyond the Basics)

This topic retrieved from UpToDate on: Mar 03, 2022.
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