Peritoneal dialysis (per-ih-toe-NEE-ul die-AL-uh-sis) is a way to remove waste products from your blood when your kidneys can't adequately do the job any longer. This procedure filters the blood in a different way than does the more common blood-filtering procedure called hemodialysis.
During peritoneal dialysis, a cleansing fluid flows through a tube (catheter) into part of your abdomen. The lining of your abdomen (peritoneum) acts as a filter and removes waste products from your blood. After a set period of time, the fluid with the filtered waste products flows out of your abdomen and is discarded.
These treatments can be done at home, at work or while traveling. But peritoneal dialysis isn't an option for everyone with kidney failure. You need manual dexterity and the ability to care for yourself at home, or you need a reliable caregiver.
During peritoneal dialysis, a cleansing fluid (dialysate) is circulated through a tube (catheter) inside part of your abdominal cavity (peritoneal cavity). The dialysate absorbs waste products from blood vessels in your abdominal lining (peritoneum) and then is drawn back out of your body and discarded.
You need dialysis if your kidneys no longer function well enough. Kidney damage generally progresses over a number of years as a result of long-term conditions, such as:
In hemodialysis, blood is removed from the body, filtered through a machine and then the filtered blood is returned to the body. Hemodialysis is typically done in a health care setting, such as a dialysis center or hospital, though it can sometimes be done at home.
Although both types of dialysis can effectively filter your blood, the benefits of peritoneal dialysis compared with hemodialysis include:
Talk with your doctor about which type of dialysis might be best for you. Factors to consider include:
Peritoneal dialysis may be the better option if you:
Peritoneal dialysis might not work if you have:
It's also likely that people using peritoneal dialysis will eventually have a decline in kidney function that requires hemodialysis or a kidney transplant.
Complications of peritoneal dialysis can include:
If you have peritoneal dialysis, you'll need to avoid:
You'll need an operation to insert the catheter that carries the dialysate in and out of your abdomen. The insertion might be done under local or general anesthesia. The tube is usually inserted near your bellybutton.
After the tube is inserted, your doctor will probably recommend waiting up to a month before starting peritoneal dialysis treatments to give the catheter site time to heal.
You'll also receive training on how to use the peritoneal dialysis equipment.
During peritoneal dialysis:
The process of filling and then draining your abdomen is called an exchange. Different methods of peritoneal dialysis have different schedules of exchange. The two main schedules are:
You fill your abdomen with dialysate, let it remain there for a prescribed dwell time, then drain the fluid. Gravity moves the fluid through the catheter and into and out of your abdomen.
Also known as automated peritoneal dialysis (APD), this method uses a machine (automated cycler) that performs multiple exchanges at night while you sleep. The cycler automatically fills your abdomen with dialysate, allows it to dwell there and then drains it to a sterile bag that you empty in the morning.
To determine the method of exchange that's best for you, your doctor will consider your medical condition, lifestyle and personal preferences. Your doctor might suggest certain modifications to individualize your program.
Many factors affect how well peritoneal dialysis works in removing wastes and extra fluid from your blood. These factors include:
To check if your dialysis is removing enough waste products, your doctor is likely to recommend tests, such as:
If the test results show that your dialysis schedule is not removing enough wastes, your doctor might change your dialysis routine to:
You can improve your dialysis results and your overall health by eating the right foods, including foods low in sodium and phosphorus. A dietitian can help you develop an individualized meal plan. Your diet will be based on your weight, your personal preferences, and your remaining kidney function and other medical conditions, such as diabetes or high blood pressure.
Taking your medications as prescribed also is important for getting the best possible results. While receiving peritoneal dialysis, you'll likely need various medications to control your blood pressure, stimulate production of red blood cells, control the levels of certain nutrients in your blood and prevent the buildup of phosphorus in your blood.