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Peritoneal Dialysis: Your First Year

Disclaimer: This article is for informational purposes only and is not intended to be a substitute for medical advice or diagnosis from a physician.

Your first year on peritoneal dialysis (PD) will be initially be an exciting time. You will learn how to perform a self therapy that allows you to have increased freedom in your day-to-day life. As you are adjusting to peritoneal dialysis, you may experience changes in your daily schedule, your self-image, your energy level and/or your home. Knowing what to expect and how to prepare may make these changes easier to deal with.

Here are some specific ways in which peritoneal dialysis may affect the different areas of your life:

Peritoneal dialysis and your daily schedule

Depending on which type of PD you and your doctor decide on, your daily routine may not be affected much at all. For example, if you choose to do automated peritoneal dialysis (APD), you will be performing your PD at night with the aid of a machine called a cycler while you sleep. The cycler will automate your PD exchanges so that you don’t have to do them manually.

If you choose to do continuous ambulatory peritoneal dialysis (CAPD), you will be manually performing your exchanges during the day. This form of PD may require an adjustment in your daily schedule to accommodate your treatments. However, many things within your daily routine will remain the same. For example, since the PD solution dwells in your abdomen most or all of the time with CAPD, your PD therapy will be going on while you run errands, mow the lawn, clean your house, watch television, spend time with your family, etc.

If you choose to do manual exchanges during the day with CAPD, you will need to get used to planning ahead. For example, if you are going to be away from your home when it is time to perform an exchange, you need to plan out where you can do your treatment safely. You can make this less of a challenge by keeping extra bags of dialysate solution at the places where you spend a lot of time, such as your workplace or daughter’s home.

APD may provide you with more freedom in your daily routine. However, if you plan to travel on APD, you may need to arrange to have dialysis solution delivered in advance to the place that you are going. This is something that can easily be arranged by your PD nurse or social worker. If staying overnight at a hotel or friend’s house, you will need to take your cycler and solution with you.

With PD, you can continue to exercise. Exercise such as yoga and bicycling are fine to do while on PD. If you would like to do more high-impact exercises, check with your doctor and PD nurse.

When it comes to your job, you should be able to keep working in your current capacity while on PD. If you use a cycler to do your PD treatments at night, you will find that your daily work schedule will not change. If you do your exchanges manually, you can often do your daytime exchanges in a clean area in your workplace during work hours so that you can continue to work full time. However, if your job requires you to lift heavy objects or over-exert yourself, you may need to look for something less physically demanding. Your doctor can help you decide whether your current job will work well with your PD treatments.

Peritoneal dialysis and your self-image

Many people on PD will carry fluid in their abdomen during the day, and this may cause your belly to bulge out somewhat. In addition, as a peritoneal dialysis patient of any kind, you will be at risk for weight gain due to the calories in the PD solution. While these changes can be disconcerting at first, it’s important to understand that they can be minimized with exercise and the help of your dietitian. If you are dedicated to eating a balanced and healthy diet and exercising, it is possible to maintain a healthy weight and keep the extra calories in the dialysate from turning into extra pounds.

Also, if you choose PD, you will be required to have a soft, flexible catheter in your abdomen. This may seem strange at first and may change the type of clothing you feel comfortable wearing. However, most PD patients get used to having a catheter and don’t mind it because of the freedom that PD gives them. Typically, the catheter is placed in such a way that it won't interfere with your normal activities. In addition, if you receive a transplant in the future, your catheter can easily be removed and will only leave a tiny scar.

Peritoneal dialysis and your energy level

Most patients first starting PD will experience an increase in energy levels due to the correction of uremia and anemia. However, energy levels can sometimes fall after starting PD due to several common reasons. For example, you could experience a drop in your energy level if you are not getting enough exercise, if your anemia is not properly managed or if your remaining kidney function decreases.

Many of the conditions that cause low energy levels in PD patients can be rectified with the help of your doctor, nurse, dietitian and/or social worker. Talk with your medical team if you feel that your energy level is not as high as it should be. Your team will work with you to pinpoint the problem and find a solution.

Peritoneal dialysis and your home

You will need to make room in your home to store your PD supplies. While the amount of supplies is not overwhelming, you may feel that your home is more crowded or has a medical feel to it. This feeling may be stronger if you use a cycler to perform APD at night because your cycler will take up space on a table near your bed or on your nightstand.

However, as you become familiar with your schedule of exchanges, you will be able to adjust your supply deliveries so that you only have to store a small amount of supplies in your home. Also, if it bothers you to see your cycler on the nightstand, try viewing it as a machine that allows you to live the full life you deserve to live, instead of simply a medical device. Thinking about your supplies and equipment in a positive way and being thankful for the benefits of at-home dialysis can help you adjust to these changes in your home.

Summary

Peritoneal dialysis is a popular option for end stage renal disease (ESRD) patients looking to have more control over their dialysis and more freedom in their lives. It is an at-home treatment option that enables you to live a lifestyle very similar to the one you lived before you began dialysis. While there may be a slight period of adjustment when you begin PD, you will likely find that the benefits of this modality far outweigh any changes you may need to make in your routine.

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