Dialysis is a treatment that filters the blood and removes waste products when the kidneys have failed, either temporarily or permanently. There are two types of dialysis, hemodialysis and peritoneal dialysis. During hemodialysis, the patient's blood is circulated through a machine to be cleaned before being returned to the body.
Peritoneal dialysis (PD), on the other hand, utilizes the body's abdominal cavity to clean the blood. With PD, a catheter is placed in the abdomen, and sterile fluid is instilled into the abdominal cavity. This sterile fluid absorbs toxins and excess fluid from the body. At regular intervals, the fluid is drained out, and new fluid is instilled. These exchanges of fluid can be tailored to the patient's schedule during the day or can be at night using a fluid cycler machine while the patient sleeps.
Benefits of Peritoneal Dialysis
PD offers the patient flexibility to adjust the timing of their fluid exchanges depending on their schedule. Many patients find they are able to continue working because of the flexibility that PD provides. PD patients also are less prone to episodes of cramps and dizziness compared to hemodialysis patients because PD allows for a more gradual cleaning process. Other benefits may include:
- Fewer medications
- Less restrictive diet
- No use of needles
- Less fluctuation of fluid balance within the body
Obstacles to Peritoneal Dialysis
There are instances when peritoneal dialysis may not be appropriate. Some of these may include:
- Extensive surgical scars in the abdomen
- A large abdominal hernia
- Inflammatory bowel disease or recurrent diverticulitis
- Limited ability for self-care and lack of care giving
The Peritoneal Dialysis Process
To prepare for peritoneal dialysis treatment, a catheter is surgically implanted in the abdomen. The placement of the catheter is done under general anesthesia and may be performed as open surgery or laparoscopically. With one end inserted in the abdomen and the other end protruding through the skin, the catheter allows the dialysis solution, known as dialysate, to flow freely in and out of the body with no need for repeated incisions.
After the catheter has been placed and an extensive training process has been completed, patients are able to perform the dialysis treatments independently at home or in any clean location. Patients instill ("fill") the dialysate into the abdomen through the catheter. After a prescribed period of time, the fluid is drained into a sterile collection bag. This process can be done manually multiple times per day, or through the use of a cycler machine at night while the patient sleeps.
Risks of Peritoneal Dialysis
Dialysis is a necessary procedure for many people who are suffering from kidney failure or kidney-related problems. While it is a necessary treatment, the risks of peritoneal dialysis may include:
- Infection in the abdominal cavity or at the site of the catheter insertion
- Weight gain or high blood sugar because the dialysate contains sugar
- Hernia because of abdominal distention