Peritoneal (Home) Dialysis

Peritoneal dialysis is another procedure that replaces the work of the kidneys, removing excess water, wastes, and chemicals from the body. Peritoneal dialysis is performed by infusing a “clean” dialysis solution into the abdomen through a special tube. (Figure 2) This solution is called dialysate.  

Peritoneal dialysis uses the natural lining inside the abdomen called the peritoneal membrane. This membrane works the same way as the dialyzer does in hemodialysis. While the dialysate dwells in the abdominal cavity fluid, wastes, and chemicals pass from tiny blood vessels in the peritoneal membrane into the dialysate.

After several hours, the dialysate is drained from the abdomen, taking the wastes with it. After draining the dialysate, the abdomen is filled with fresh dialysate and the cleaning process begins again. The inflow-dwell-drainage cycle is called an exchange.

Figure 2

There are two types of peritoneal dialysis: Continuous Ambulatory Peritoneal Dialysis (CAPD):

• CAPD needs no machine. It can be done in any clean, well-lit place. With CAPD the blood is always being cleaned. The dialysate passes through the catheter into the abdomen and remains there for a period of time. After several hours, the dialysate is drained from the abdomen and fresh dialysate is put back into the abdomen. The process of exchanging the dialysis fluid is repeated four to six times each day. Each day, the final dialysis is performed just before going to bed at night. When the dialysate dwells in the abdomen, the empty solution bag is folded and hidden under the clothing.
  
• Continuous Cyclic Peritoneal Dialysis (CCPD): CCPD is very similar to CAPD except the exchanges are performed using an automatic cycling machine. The machine does the dialysis at night while you are asleep. The machine makes several evenly spaced exchanges during the night and one final exchange just before you get up in the morning. Treatments last 10 to 12 hours every night.