How the Peritoneal Dialysis process works

PD actually cleans your blood and removes extra fluids using one of your body's own natural filters, the peritoneal membrane. The peritoneal membrane is the lining that surrounds the peritoneal cavity, which is in your abdomen and contains your stomach, spleen, liver, and intestines. During the PD process (usually called an exchange), a solution is placed in the peritoneum through a catheter and the peritoneal membrane acts as a filter and draws waste and fluids from your blood into the solution. Once the solution is full of waste, it’s drained through the catheter and exchanged with a fresh solution.

PD Exchange

There are two types of Peritoneal Dialysis

1. Automated Peritoneal Dialysis (APD) or CCPD

APD is usually done overnight, with a cycler machine that performs exchanges automatically, while you sleep. APD is good for people who want more freedom from dialysis during the day. Since you don’t have to do exchanges during the day, you have more independence.

2. Continuous Ambulatory Peritoneal Dialysis (CAPD)

CAPD cleans your blood most hours of the day, 7 days a week. And you can walk around, even during exchanges. Exchanges usually take about 30 minutes 3-4 times a day and only require a solution bag with tubing attached to it that connects to your catheter. The fluid from the solution bag "dwells" in your abdomen for about five hours, drawing waste products and excess fluid from the bloodstream. An exchange can be performed in any clean area - at home, work or while traveling.

There are quite a few advantages to the Peritoneal Dialysis process

PD provides continuous therapy, so it acts more like your natural kidneys. It also offers a more flexible lifestyle and allows you to maintain your independence. You can even do your exchange overnight, while you sleep. And since you don’t have to travel to a dialysis unit for treatment, you can cut your clinic visits down to about once a month.

PD maintains residual kidney function

PD helps preserve a patient's residual kidney function^1,2. If you still have some residual kidney function and are interested in a kidney transplant, PD may be a good option. In fact, PD patients have been shown to be more likely to have a transplant when compared to HD patients³.

PD helps preserve access to your veins

It may happen that over a number of years on dialysis, you may need to use multiple types of therapy. That's why it's important to keep your options for access open. Because PD is administered through a catheter in your abdominal cavity, your veins are not involved and the integrity of the veins can be preserved.

PD requires training and space in your home

With PD, you have to be responsible to do your treatment every day as you were trained. PD patients must maintain a clean environment and need space in the home for dialysis supplies.

Is PD right for you?

Several conditions may prevent your doctor from prescribing PD, including previous abdominal surgeries or the presence of intestinal diseases, such as inflammatory bowel disease or diverticulitis. Risks of PD include peritonitis or exit-site infections. Glucose found in the PD solution may lead to high blood sugar in patients with diabetes. Every patient is different, so it is important to talk to your doctor, nurse or social worker to determine if there are other reasons why PD may not be right for you.

^1. Lysaght M, Vonesh E, Gotch F, et al. "The influence of dialysis treatment modality on the decline of remaining renal function." ASAIO Trans. 1991;37: 598-604.
^2. Moist L, Port F, Orzol S, et al. Predictors of Loss of Residual Renal Function among New Dialysis Patients. J Am Soc Nephrol. 2000;11:556-564.
^3. Snyder J, Kasiske L, Gilbertson D, et al. "A comparison of transplant outcomes in peritoneal and hemodialysis patients." Kidney International 2002;62: 1423-1430.