Home Peritoneal Dialysis
Peritoneal dialysis (PD) is a form of dialysis done at home either by the patient or, in some cases, with the assistance of care giver.
Benefits of Peritoneal Dialysis versus In-Centre Hemodialysis
How PD Works
With PD, the blood is cleaned inside the body, using it as a natural filter. It is a more gentle form of dialysis, that lets your kidneys hold onto their remaining function longer.
A peritoneal catheter (soft tube) is placed into the peritoneal cavity in your belly (under the ribs and above the hips). The peritoneal cavity membrane surrounds internal organs and is the filter that will be used to clean the blood.
Using the catheter, the peritoneal cavity is filled with clear fluid (called dialysate). Over time the fluid put into your body will collect waste. This waste fluid is then drained through the catheter before fresh fluid is put in again. This is called a PD exchange.
Schedule
A patient choosing PD dialyzes seven days a week, usually overnight while they sleep. Patients only need to visit the PD clinic every two to four months for assessment by health-care team members.
Types of Peritoneal Dialysis
Manual or Twin Bag Method
aka CAPD (Continuous Ambulatory Peritoneal Dialysis)
- Is the first method to be taught
- No machine is used, only gravity
- Dialysate fluid stays in the peritoneal cavity (belly area) at all times
- Exchanges are done by the person four to five times every day
- Each exchange can take about 30 minutes to complete
Automatic/Cycler Method – CCPD (Continuous Cycling Peritoneal Dialysis) or APD (Automated Peritoneal Dialysis)
- Done by a compact, portable machine overnight for about nine hours while asleep
- Dialysate fluid stays in the belly cavity for short periods of time before the machine drains it out and fills with fresh dialysate (this is called cycling)
- In the morning one last fill will occur before disconnecting
- This fluid may stay in the belly cavity the entire day
- In some cases, people using the automatic method may have to do a manual exchange during the day
What You Will Need
The patient will need to have the following at home in order to have the best possible environment for PD:
- Telephone
- Clean work area
- Storage space for supplies
- Suitable water, plumbing and electricity
- Digital scale and Blood Pressure Machine
Training & Clinic Visits
PD training takes three to five days, happens daily (weekdays) and is provided by PD nurses at the hospital. Once training is complete, PD nurses are available for questions and there is 24-hour support for PD machines. Clinic appointments for PD patients are every two to four months.
Getting There
Talk with your health-care team if you plan on driving to training or if you need help arranging transportation.
Responsibilities
Being on home dialysis means managing one’s own care. While this is a responsibility, it also allows freedoms such as setting the dialysis schedule. The patient will have to ensure they are willing and able to:
- Manage their own care
- Order supplies monthly
- Attend clinic appointments
Catheter
If a patient decides to move forward with peritoneal dialysis as their choice of treatment, they will receive a catheter in their belly area.
Catheter surgery takes about an hour and requires only a few hours stay in hospital (not overnight).
The catheter will need a few weeks to heal before the individual is trained on doing their own peritoneal dialysis treatments.
Individuals are taught how to keep their catheter site clean and monitor it for any sign of infection. Keeping the site clean is important and will reduce the chance of infection. If you have concerns or questions about your catheter site, always ask the health-care team.
Eating & Drinking
PD can offer a bit of flexibility when it comes to food intake particularly when it comes to potassium. Every person on dialysis has different needs and restrictions so talk to your renal dietitian who will customize a special diet for you. Always talk to the dietitian if there are concerns about nutritional needs. Visit the Nutrition & Peritoneal Dialysis section by clicking the button below.
Where to Start
Interested in learning more about peritoneal dialysis? Our Transition Coordinator can visit with you or talk to you on the phone about dialysis options. Call 204-631-3022 to talk to the Transition Coordinator or email kidneyhealth@sharedhealthmb.ca. This is an easy way to learn more about your options.
Assessment:
An assessment appointment is a great way to find out if peritoneal dialysis (PD) is a good fit for you. During the appointment different care team members may ask questions and:
- Review the entire process of Peritoneal Dialysis with you
- Show you peritoneal dialysis equipment and supplies
- Answer any questions or concerns you may have
- Ask you to perform some simple tasks to determine if you would need assistance with PD or not
It is recommended to bring a partner or support person to the assessment meeting if possible. After the PD assessment, if the patient and health-care team agree PD is a good option for the patient, they will work with the patient to plan the steps towards education and training.
