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By Mark H. Shapiro, MD
Disclaimer: This article is for informational purposes only and is not intended to be a substitute for medical advice or diagnosis from a physician.
Peritoneal dialysis (PD) is an excellent form of therapy for many people with kidney failure. It's estimated that up to 80 percent of people with end stage renal disease (ESRD) are capable of doing PD, and it may be a better form of dialysis therapy for 25-30 percent of people requiring dialysis. With the help of your nephrologist, close family members and resources both in print and online, you can determine whether this home dialysis treatment option is right for your lifestyle.
In order to perform PD, you will need to have a PD catheter placed into your abdomen. A PD catheter is a flexible plastic tube that allows dialysis fluid to enter the abdominal cavity, dwell inside for a while, and then drain back out again. PD catheter placement is considered a minor operation, and complications are rare. It often requires general anesthesia, but the whole procedure takes less than one hour of surgical time. Most catheters have two Dacron cuffs that remain inside the abdominal wall to keep it in place. Typically, a surgeon at a hospital will perform the procedure. However, there are some nephrologists and radiologists who are also trained to place PD catheters.
In general, it is best to have the catheter placed at least two weeks before actually beginning PD. In some cases, PD may start within a few days of having the catheter placed. Using the catheter early may increase the risk of having a leak, which is the most common complication after surgery.
The following is generally what you can expect when undergoing PD catheter surgery, but also ask your physician about what the process may be like for your individual case.
PD catheter surgery is a minor operation, but it's still important to know what to expect before having this procedure. After the catheter is placed, the primary goals are to keep the exit site clean and prevent the catheter from pulling on the exit site. A PD catheter, when placed properly, shouldn't interfere with most everyday activities. PD catheters that are properly cared for can often be used without problems for many years. Learning everything there is to know about PD—including PD catheter placement—can help you succeed on this type of home dialysis treatment.
Dr. Shapiro is a nephrologist who practices in Escondido, Calif. He did his undergraduate training at University of California, Los Angeles, obtained his medical degree at the University of Pittsburgh, and completed his residency training and nephrology fellowship at the University of California, San Diego.
Dr. Shapiro is an Assistant Professor of Medicine at University of California, San Diego, and also maintains an active private nephrology practice in the San Diego area. His primary area of medical interest is in peritoneal dialysis (PD). Dr. Shapiro was a medical advisor for PD within Gambro Healthcare, Inc., and more recently was named the national peritoneal dialysis medical advisor within DaVita Inc. In addition, he serves on the Physician Advisory Council and the Pharmacy and Therapeutics Committee within DaVita.
Dr. Shapiro is married and has two sons. He enjoys kayaking, fishing and most other outdoor sports.
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