Peritoneal Dialysis
Definition
Dialysis is a treatment that takes over the job of your kidneys. There are two types of dialysis. This fact sheet will focus on peritoneal dialysis. It uses the lining of your abdomen and a special solution to filter your blood.
Reasons for Procedure
The kidneys have many important jobs. They clear toxins out of your blood and help balance fluid and mineral levels in the body. Dialysis may be needed if the kidneys are not able to work well. It may be started when the kidneys have lost more than 90% of their function.
The main functions of peritoneal dialysis are to:
- Remove wastes and extra fluids from your blood
- Control blood pressure
- Keep a safe level of items in the body, such as potassium, sodium, and chloride
Dialysis may be used short term to allow your kidneys to rest and heal. If the kidney damage is permanent, dialysis will be needed for the rest of your life. It can improve the quality and length of life in people with severe kidney disease.
People with obesity or previous surgery in the belly area may not be able to use this type of dialysis.
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Fluid leaking around the catheter
- Infection in the belly— peritonitis
- Infection around the catheter
- Constipation
- Failure to drain or instill the fluid
- Muscle cramps
- Nausea, vomiting
- Headaches
- Feeling hot, sweaty, weak, and/or lightheaded
- Disruption of calcium and phosphorus balance, resulting in weakened bones
The doctor will talk about ways to lower the risk of problems. Steps that can help are:
What to Expect
Prior to Procedure
A small, soft tube about 24 inches long will be placed in the belly. One part of the tube will remain outside of the body. It may need to be placed 10 to 14 days before it can be used. It will need regular care to decrease the risk of infection.
Description of the Procedure
A solution, called a dialysate, is passed through your tube. It will remain in the belly wall for the next few hours.
The lining of the belly has many tiny blood vessels. The solution sits next to these blood vessels. Fluid, waste, and chemicals can move from the blood vessels into the solution. After several hours, the solution will be drained through the tube. It will take waste from the blood with it. New solution may then be added to repeat the process.
There are different delivery options:
- Continuous ambulatory peritoneal dialysis (CAPD)—This is the most common type. The solution remains for 3 to 6 hours. It will then be drained and refilled. It may be repeated 3 to 5 times over the day. This type can often be done at home. You can do normal activity while the solution is in.
- Continuous cyclical peritoneal dialysis (CCPD)—A machine fills and drains the abdomen. It is often done at night while you sleep.
- Intermittent peritoneal dialysis (IPD)—Uses the same type of machine as CCPD. It is often done at a hospital or center. It also takes longer than CCPD.
How Long Will It Take?
The time needed for peritoneal dialysis depends on a few factors:
- How much kidney function remains
- How much fluid weight gain has occurred since the last round
- Amount of waste in the body
- Body size
- Level of salts, such as sodium, potassium, and chloride, in your body
- Peritoneal dialysis type used
| Type | Length of Time | How Often |
|---|---|---|
| CAPD | 3-6 hours, plus 30 minutes to drain | 4 times/day |
| CCPD | 9-12 hours | Every night |
| IPD | 12 + hours | 36-42 hours/week |
Will It Hurt?
In general, it does not cause pain.
Post-procedure Care
Be sure to follow your doctor’s instructions. There are some special considerations.
You may need a special diet. This will help your overall health. It can also make treatment more effective. Ask your doctor about your specific needs.
Call Your Doctor
Contact your doctor if any of the following occur:
- Signs of infection, including fever and chills
- Redness, swelling, warmth, increasing pain, excessive bleeding, or discharge at the catheter or tube insertion site
- Blood or cloudiness in the peritoneal dialysis fluid
- Nausea or vomiting
- Belly pain
- Lightheadedness
If you think you have an emergency, call for emergency medical services right away.
RESOURCES:
National Institute of Diabetes and Digestive and Kidney Diseases
https//www.niddk.nih.gov
National Kidney Foundation
https://www.kidney.org
CANADIAN RESOURCES:
Health Canada
https://www.canada.ca
The Kidney Foundation of Canada
https://www.kidney.ca
REFERENCES:
Dialysis. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/atozTopic_Dialysis. Accessed June 11, 2020.
Peritoneal dialysis: Dose & adequacy. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/peritoneal-dialysis-dose-and-adequacy/Pages/facts.aspx. Updated September 2010. Accessed June 11, 2020.
Peritoneal dialysis for end-stage renal disease. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T913135/Peritoneal-dialysis-for-end-stage-renal-disease. Accessed June 11, 2020.
Last reviewed December 2020 by EBSCO Medical Review Board Adrienne Carmack, MD Last Updated: 6/7/2020