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While end stage renal disease (ESRD) can be challenging for anyone to live with, it can be particularly difficult for children, especially school-age children who are trying to fit in and make friends. Peritoneal dialysis (PD) is a home dialysis option that allows children with ESRD to dialyze at home and lead a more normal, active life while getting treatment for kidney failure.
PD is a form of home dialysis that uses the peritoneal membrane in the abdomen to clean the patient’s blood. During a process known as an exchange, a special solution, called dialysate, is put into the peritoneal cavity through a catheter (small tube) that has been placed in the patient’s abdomen. The dialysate dwells, or stays, in the abdomen for a prescribed period of time. While it dwells, the dialysate absorbs extra fluid and wastes from the blood. When the dwell time is up, the dialysate is drained from the abdomen and takes the extra fluid and wastes with it.
Automated peritoneal dialysis (APD) - APD, commonly referred to as continuous cycling peritoneal dialysis (CCPD), requires a cycler machine to automate the filling and draining process of the exchange. Many children prefer this form of PD because it allows most of their dialysis to be performed while they sleep, freeing up the day for school and other activities.
Before a child can begin PD, he or she will need to have a PD catheter surgically placed in his or her abdomen. A catheter is a soft, flexible tube about the length of a ruler and the width of a pencil. During surgery, one end of the catheter will be put into the child’s peritoneal cavity and the other end will come out of a tiny hole in the lower abdomen. Catheter placement surgery is usually done under general anesthesia, and most patients go home the day of the procedure.
When the catheter exit site has healed and the catheter is ready to use for PD, the child and his or her parent or guardian will go through a comprehensive safety and training class at a dialysis clinic to learn how to do PD. The child will take an active part in the training and will be assigned age-appropriate tasks to be done during the treatment. Training will be done by a PD nurse and generally takes about two weeks. As the child gets older and learns more about PD, he or she will be able to take on more of the tasks associated with the child's treatment.
PD is an option for children with ESRD that makes it easier for them to maintain an active lifestyle and keep up with children their age. Talk with your child’s doctor today to see if PD is the right dialysis treatment for your child.
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