Peritoneal Dialysis: A Home Dialysis Choice for People with Kidney Failure
By Dr. Mark Shapiro
What is PD?
Peritoneal dialysis (PD) is currently the most common home dialysis treatment option. Among nephrologists (kidney doctors) worldwide, PD is considered one of the top initial and long-term therapies.1 PD is generally performed every day—either manually during the day or at night using a cycler machine. Many people choose PD because it fits well into their lifestyles and provides more control over their treatment program.
DaVita® trains thousands of people with end stage renal disease each year to treat their dialysis at home with PD. In fact, we are the largest provider of PD in the United States.2
How PD works
When your kidneys stop working, toxins and fluid build up in the body and cannot be released. PD uses the lining of your abdomen (belly) to gently remove this waste buildup from the blood through a solution known as dialysate. Instead of needles, dialysate gets passed in and out through a surgically placed tube, called a catheter, in your abdomen. The soft, flexible catheter is about the width of a pencil and can easily be hidden under your clothes as you go about your day. Over several hours, the fluid pulls waste from your blood and exits the body by way of the catheter. Because PD treatments can be performed several times a day, it is the dialysis option most similar to your natural kidney function.
Your catheter remains permanently in the abdomen, and is taped down on the outside of the body so that it doesn’t interfere with everyday activities such as work, exercise, recreation, showering or sexual activity.
Watch how PD works.
Types of PD
There are two types of PD (manually during the day or using a cycler machine at night) and both can be performed at home. Your nephrologist can help you decide which option best meets your needs. Both options can help offer more flexibility by allowing patients to dialyze at home, at work or on vacation. Either type can enable you to possibly live a lifestyle similar to the one you lived before you began dialysis.
Continuous Cycling Peritoneal Dialysis (CCPD)
CCPD, also referred to as automated peritoneal dialysis (APD), requires a cycler machine to automate the process of filling and draining dialysate in your abdomen. Most people choose CCPD because it allows most of their dialysis to be performed at night, which frees up the day for work, school or other activities. The cycler is programmed to perform three to five fluid exchanges while you sleep, usually over an 8- to 10-hour time period. Most people get used to sleeping while on a cycler rather quickly and have few problems. Cycler machines are also small enough to be set on your bedside table.
Continuous ambulatory peritoneal dialysis (CAPD)
With CAPD, you can perform your dialysis exchanges manually without a machine. Exchanges, which is the act of removing toxins and buildup in the body, can take approximately 30 minutes and are generally performed four times during the day by placing a bag of dialysate fluid on an IV pole. Gravity then makes the filling and draining process possible. This form of PD can even be done while you’re at work, as long as you have a clean environment to perform the exchanges.
Transitioning from in-center dialysis to PD
Many people who start in-center hemodialysis may transition to a home dialysis treatment. You may have more freedom and flexibility, but you certainly won’t be alone. You’re only a phone call away from a highly trained home dialysis clinical team that’s dedicated to delivering superior care and making your experience as comfortable as possible—an on-call nurse is available 24/7, as is vendor support for your PD cycler.
- Schiller et al. Nephrology News and Issues. 2010; 24(10):36,38,40
- Nephrology News and Issues. July 2018.
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