Peritoneal dialysis

Peritoneal dialysis is a type of at home dialysis performed by running dialysate into a catheter through the peritoneum (a protective membrane that lines the abdominal cavity). This allows blood to be filtered inside the body. Because peritoneal dialysis filters blood inside the body, there are fewer equipment requirements than at home hemodialysis. Many patients perform peritoneal dialysis at home or at work without assistance.

Prior to beginning peritoneal dialysis treatment, a small, flexible catheter is placed by a surgeon in your abdomen. This catheter is used to fill your abdominal cavity with a warmed, specially prepared fluid called dialysate (dialysis solution). The dialysate stays in your abdomen for several hours and absorbs waste and excess fluid from your blood. You then drain it out and replace it with fresh dialysate.

Types

There are two types of peritoneal dialysis:

• Continuous Ambulatory Peritoneal Dialysis (CAPD)
  Performed four to five times per day without a machine.
• Continuous Cycler-Assisted Peritoneal Dialysis (CCPD)
  To reduce the number of daytime exchanges, patients undergoing peritoneal dialysis can use an assist machine (called a cycler) to do exchanges, usually while they sleep at night.

Peritoneal dialysis patients generally perform four to five fill-and-drain exchanges per day.

Peritoneal dialysis vs home hemodialysis

Advantages

Advantages	Peritoneal dialysis		Home hemo dialysis
	CAPD	APD	Short daily	Traditional	Extended / Nocturnal
Flexible treatment time
Fewer diet and fluid restrictions
Portable for ease of travel			1
Needle-free treatments
Dialyze while you sleep
Fewer peaks and valleys
Doctor visits and labs performedonce a month at the clinic

1. Using NxStage prepackaged fluids for travel

Disadvantages

Disadvantages	Peritoneal dialysis		Home hemo dialysis
	CAPD	APD	Short daily	Traditional	Extended / Nocturnal
Requires space for supplies			1
Potential weight gain
Requires modifications to home (electrical and plumbing)
Care partner required

1. Using NxStage prepackaged fluids for travel

Training and check ups

Treatment	Training frequency (days per week)	Length of training (weeks)	Length of each training session (hours)	Frequency of clinic visit (visits per month)
CAPD	3 - 5	1 - 3	4 - 6	1-2
APD	3 - 5	1 - 3	4 - 6	1-2
Short daily	5	3 - 4	4 - 6	1-2
Traditional	3	4 - 5	4 - 6	1-2
Extended / nocturnal	3	4 - 5	4 - 6	1-2