Why is this procedure done?
The kidneys are bean-shaped organs in the back of your belly, just above your waist. They filter your blood and get rid of waste products and extra fluid from your body. The waste is turned into urine. Sometimes, your kidneys do not work well. Then, you may need a procedure to replace the work of your kidneys. � �
Peritoneal dialysis, or PD, takes over the work of your kidneys. It removes extra water, wastes, and chemicals from your body when your kidneys are not working as usual. This type of dialysis uses the lining of your belly to filter the wastes from your blood. This lining is called the peritoneal membrane or peritoneum. � �
A peritoneal dialysis is made up of a cleansing solution or dialysate, a tube or PD catheter, and a bag or container to drain the fluid. You may also need a small machine to do dialysis while you sleep. The tube that goes into your belly has about 6 to 12 inches outside the belly. The solution enters your body through the tube and then drains out through the same tube. The solution that drains out has all the waste in it. The solution going in and then draining out is called a PD exchange. � �
The PD exchange is done 2 to 3 weeks after the tube is put in, which lets the area around the tube heal before PD is started. � �
There are a few types of PD: � �
- Continuous ambulatory peritoneal dialysis or CAPD is done 3 to 5 times during the day.
- Continuous cycler peritoneal dialysis or CCPD uses a small machine called a cycler. The exchanges are done 3 to 5 times while you sleep at night.
- Manual intermittent PD is done a few times during the day. The solution is put in and drains out at the same time.
- Automated cycler intermittent PD is a machine that does exchanges at set times. It is most often done 6 to 7 times a week.
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What will the results be?
Wastes and extra fluid will be removed from your body. This will help keep your blood pressure and the minerals in your body normal. � �
What happens before the procedure?
Your doctor will take your history and do an exam. Talk to your doctor about: � �
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin � �, ibuprofen, Aleve � � (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
What happens during the procedure?
How to Do a PD Exchange at Home or in the Office � �
- Do the exchange in a clean room and close all doors, vents, and windows. Keep pets out of the room.
- Place the dialysate solution in a warmer 30 to 90 minutes before doing the exchange.
- Go to the bathroom to empty your bladder and then weigh yourself before the exchange. Record your weight.
- Wash your hands before handling the PD supplies. Make sure all supplies you need are on a clean table beside you.
- Wipe the opening of the solution bag and your tube with an alcohol wipe. Connect the tube from the bag to your PD tube. Put the bag on the I.V. pole or on a clean table. Sit in a comfortable chair during the exchange.
Timing for PD Exchanges � �
- CAPD: Fill your belly with the solution and let it stay in there for up to 4 hours. After 4 hours, reconnect the PD tube to the bag and put the bag lower than your belly. This will allow gravity to drain the solution out of your belly. Repeat the process at night, but let the solution stay in your belly while you sleep. Drain the solution out in the morning.
- CCPD: Connect the cycler to your PD tube before you lie down to sleep at night. The cycler will put the solution in and out of your belly while you sleep. You can disconnect your PD catheter from the machine in the morning.
- Manual intermittent PD: The exchange is the same as for CAPD, but done a few times a day. The solution stays in your belly for 60 to 90 minutes. Connect the bag with solution and the bag for draining to your PD tube at the same time.
- Automated cycler intermittent PD: Is done in a hospital or dialysis center. A timed device puts the solution in and drains it out at set times. This type of dialysis takes longer than CCPD.
What happens after the procedure?
- Your doctor will tell you how often you should do these exchanges and what type of PD you will do.
- If intermittent PD is done, you may go back to your normal activities after the procedure.
- Keep your PD exchange supplies in a clean, dry space after using them.
What lifestyle changes are needed?
- Do not lift heavy things or do hard activities after the PD tube is put in.
- Limit your activities when your belly is full of solution during an exchange.
- You can go to work and be active, but ask your doctor what amount of activity is right for you.
- Try not to go to crowded places where your belly can easily be bumped.
What drugs may be needed?
The doctor may order drugs to: � �
- Help with pain
- Prevent infection
What problems could happen?
- Infection
- Bleeding
- Anemia
- Upset stomach and throwing up
- A bulge in the bellys muscle. This is a hernia.
- Bone weakening
- Too much sugar in the body known as hyperglycemia
- Weight gain
Helpful tips
- Loop your PD tube to make a "C " � shape before putting the dressing on. This will give a little support if you accidentally pull on your tube.
- Wear loose clothing that will not rub on your tube.
- Ask your doctor about underwear and belts made for people with PD tubes.
- Do not warm your PD solution in a microwave.
- Schedule when you need to get supplies so you do run out of them.
Where can I learn more?
Kidney Dialysis Information Centre � �
http://www.kidneydialysis.org.uk/peritoneal-dialysis.htm � �
National Kidney and Urologic Diseases Information Clearinghouse � �
http://kidney.niddk.nih.gov/kudiseases/pubs/peritonealdose/index.aspx � �
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. � �
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