Dialiss

Treatment Methods for Kidney Failure

PERITONEAL DIALYSIS

U.S. Department of Health and Human Services

NATIONAL INSTITUTES OF HEALTH National Kidney and Urologic Diseases Information Clearinghouse

Treatment Methods for Kidney Failure

PERITONEAL DIALYSIS

NATIONAL INSTITUTES OF HEALTH National Institute of Diabetes and Digestive and Kidney Diseases

Contents
Introduction . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 When Your Kidneys Fail . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 How PD Works . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Getting Ready for PD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Types of PD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . 4 Customizing Your PD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Preventing Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Equipment and Supplies for PD . . . . . . . . . . . . . . . . . . . . . . 7 Testing the Effectiveness of Your Dialysis . . . . . . . . . . . . . . 12 Conditions Related to Kidney Failure and Their Treatments . . . . . . . . . .. . . . . . . . . . . . . . . . . . . 14 Adjusting to Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Hope Through Research . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Introduction
Withperitoneal dialysis (PD), you have some choices in treating advanced and permanent kidney failure. Since the 1980s, when PD first became a practical and widespread treatment for kidney failure, much has been learned about how to make PD more effective and minimize side effects. Since you don’t have to schedule dialysis sessions at a center, PD gives you more control. You can give yourself treatments athome, at work, or on trips. But this independence makes it especially important that you work closely with your health care team: your nephrologist, dialysis nurse, dialysis technician, dietitian, and social worker. But the most important members of your health care team are you and your family. By learning about your treatment, you can work with your health care team to give yourself the bestpossible results, and you can lead a full, active life.

When Your Kidneys Fail
Healthy kidneys clean your blood by removing excess fluid, minerals, and wastes. They also make hormones that keep your bones strong and your blood healthy. When your kidneys fail, harmful wastes build up in your body, your blood pressure may rise, and your body may retain excess fluid and not make enough red bloodcells. When this happens, you need treatment to replace the work of your failed kidneys.

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How PD Works
In PD, a soft tube called a catheter is used to fill your abdomen with a cleansing liquid called dialysis solution. The walls of your abdominal cavity are lined with a membrane called the peritoneum, which allows waste products and extra fluid to pass from your blood into the dialysissolution. The solution contains a sugar called dextrose that will pull wastes and extra fluid into the abdominal cavity. These wastes and fluid then leave your body when the dialysis solution is drained. The used solution, containing wastes and extra fluid, is then thrown away. The process of draining and filling is called an exchange and takes about 30 to 40 minutes. The period the

Dialysissolution

Abdominal cavity

Catheter

Peritoneum

Peritoneal dialysis.

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dialysis solution is in your abdomen is called the dwell time. A typical schedule calls for four exchanges a day, each with a dwell time of 4 to 6 hours. Different types of PD have different schedules of daily exchanges. One form of PD, continuous ambulatory peritoneal dialysis (CAPD), doesn’t require a machine. As...