When is peritoneal dialysis used

You have more freedom to work and be social— thanks to a more flexible schedule. You can even do PD in your sleep. PD is considered to be gentler on your body— including your heart. You may experience fewer side effect than with other forms of dialysis. Consider home peritoneal dialysis Home PD is closest to natural kidney function.

Find out if it may be a good option for you. Factors to consider with home peritoneal dialysis A peritoneal catheter a soft, flexible tube will be surgically placed in your abdomen. Typically, PD catheter surgery is a minor operation that takes less than one hour.

You will likely be placed under general anesthesia and go home the same day. After your PD catheter is placed, you will need to avoid swimming, bathing, or showering for 2 weeks, or according to your care teams instructions. This is to protect the dressings from the operation during recovery, as they are not waterproof. You may use a washcloth or sponge to clean your body, while ensuring your PD catheter access site remains dry.

Following certain precautions will help you avoid the risk of an infection called peritonitis. Your nurse will give you instructions on how to avoid infection. You will need ample storage space for your supplies. If you have diabetes , know that your doctor may need to adjust your dose of insulin. You should expect to do treatments every day, 7 days a week—as prescribed by your nephrologist.

You will visit your clinic once or twice a month for laboratory testing and check-ins with your doctor and care team. Time needed to do peritoneal dialysis The time needed to do peritoneal dialysis may depend on the type of PD you choose. Your care team will be able to provide you with more details about how much time it will take for your peritoneal dialysis treatment. Find out what to plan for and how to care for your access.

At the beginning of an exchange, you will remove the disposable cap from the transfer set and connect the set to a tube that branches like the letter Y. One branch of the Y-tube connects to the drain bag, while the other connects to the bag of fresh dialysis solution. During an exchange, you can read, talk, watch television, or sleep. Dialysis solution comes in 1. Solutions contain a sugar called dextrose or a compound called icodextrin and minerals to pull the wastes and extra fluid from your blood into your abdominal cavity—the space in the body that holds organs such as the stomach, intestines, and liver.

Different solutions have different concentrations of dextrose or icodextrin. Your doctor will prescribe a formula that fits your needs. You will need a clean space to store your bags of solution and other supplies. You will also need to warm each bag of solution to body temperature before use. You can use an electric blanket or let the bag sit in a tub of warm water. Most solution bags come in a protective outer wrapper, and you can warm them in a microwave.

Do not microwave a bag of solution after you have removed it from its wrapper. In automated peritoneal dialysis, the cycler is the machine that automatically fills and drains your belly. You can program the cycler to give you different amounts of dialysis solution at different times. Most cyclers include the following:. Automated peritoneal dialysis uses a machine called a cycler to fill and empty your belly three to five times during the night while you sleep.

With continuous ambulatory peritoneal dialysis, you will perform the exchanges manually, following these steps:. You may not be able to do all the things you used to do. Adjusting to the effects of kidney failure can be difficult. You may have less energy. You may need to make changes in your work or home life, giving up some activities and responsibilities.

Following your schedule of exchanges will require some adjustment. If you do continuous ambulatory peritoneal dialysis during the day, you have some control over when you do the exchanges. A few times every day you must stop your normal activities and take about 30 minutes to perform an exchange.

If you do automated peritoneal dialysis at night, you will have to set up your cycler every night. You may have to go to bed early to get all the hours of dialysis prescribed by your doctor. Keeping the same schedule you kept when your kidneys worked can be difficult now that your kidneys have failed. Accepting this new reality can be hard on you and your family.

A counselor or renal social worker can answer your questions and help you cope. Renal social workers specialize in helping people with chronic kidney disease CKD and kidney failure. Your health care team will perform several tests to tell if your dialysis exchanges are removing enough wastes. These tests are especially important during the first weeks of treatment to determine whether your schedule is adequate.

For a peritoneal equilibration test, a dialysis nurse takes samples of your blood and dialysis solution during a 4-hour exchange. The peritoneal equilibration test measures how much dextrose your body absorbs from a bag of dialysis solution. The peritoneal equilibration test also measures how much urea and creatinine—waste products of normal muscle and protein breakdown—move from your blood into the dialysis solution.

For a clearance test, you will collect the used dialysis solution from a hour period. A dialysis nurse takes a blood sample during the same hour period. Your doctor or nurse compares the amount of urea in the used solution with the amount in your blood to see how much urea was removed. For the first months or even years of peritoneal dialysis treatment, you may still produce small amounts of urine. If you produce more than milliliters 3 ounces of urine per day, you will also collect your urine to measure its urea content.

These measurements will show whether you are using the right peritoneal dialysis schedule and doses. If your dialysis schedule is not removing enough wastes, your doctor will make adjustments. The most common problem with peritoneal dialysis is peritonitis, a serious abdominal infection. This infection can occur if your exit site becomes infected or if the catheter becomes contaminated as you connect or disconnect it from the bags.

Doctors treat peritonitis with antibiotics, which are added to the dialysis solution that you can usually take at home. Your health care team will show you how to keep your catheter clean to prevent peritonitis. Newer catheters protect against the spread of bacteria; however, peritonitis is still a common problem that sometimes makes continuing peritoneal dialysis impossible.

Here are some general rules:. Report these signs of infection to your doctor immediately so he or she can treat peritonitis quickly to prevent additional problems:. When dialysis solution stays in the body too long, it becomes so full of wastes and extra fluid that it cannot absorb any more from the body. The process may even reverse, letting some wastes and extra fluid back into the body.

The body also absorbs dextrose from the dialysis solution, which can cause weight gain because dextrose contains calories. With continuous ambulatory peritoneal dialysis, you might have a problem with the long overnight dwell time. If your body absorbs too much fluid and dextrose overnight, you may be able to use a minicycler to exchange your solution once while you sleep. This extra exchange will shorten your dwell time, keep your body from absorbing too much fluid and dextrose, and filter more wastes and extra fluid from your body.

With automated peritoneal dialysis, you may absorb too much solution during the daytime exchange, which has a long dwell time. You may need an extra exchange in the midafternoon to keep your body from absorbing too much solution and remove more wastes and extra fluid from your body. United States citizens who have kidney failure are eligible to receive Medicare. Treatment for kidney failure is expensive; however, Medicare pays much of the cost, usually up to 80 percent.

Often, supplemental insurance pays the rest. State Medicaid programs help people who are not eligible for Medicare or who still need help with the portion that Medicare does not cover. Medicaid programs provide funds for health care based on financial need. Your renal social worker can help you locate resources for financial assistance.

Eating the right foods can help you feel better while on peritoneal dialysis. Your dietary needs will depend on your treatment and other factors such as your weight and activity level. Staying healthy with CKD requires watching what is in your diet:. You may have a difficult time changing your diet at first. Eating the right foods will help you feel better. You will have more strength and energy. What are clinical trials, and are they right for you?

Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses.

What clinical trials are open? Your doctor might suggest certain modifications to individualize your program. Many factors affect how well peritoneal dialysis works in removing wastes and extra fluid from your blood.

These factors include:. To check if your dialysis is removing enough waste products, your doctor is likely to recommend tests, such as:.

If the test results show that your dialysis schedule is not removing enough wastes, your doctor might change your dialysis routine to:. You can improve your dialysis results and your overall health by eating the right foods, including foods low in sodium and phosphorus.

A dietitian can help you develop an individualized meal plan. Your diet will be based on your weight, your personal preferences, and your remaining kidney function and other medical conditions, such as diabetes or high blood pressure. Taking your medications as prescribed also is important for getting the best possible results.

While receiving peritoneal dialysis, you'll likely need various medications to control your blood pressure, stimulate production of red blood cells, control the levels of certain nutrients in your blood and prevent the buildup of phosphorus in your blood.

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Peritoneal dialysis Open pop-up dialog box Close. Peritoneal dialysis During peritoneal dialysis, a cleansing fluid dialysate is circulated through a tube catheter inside part of your abdominal cavity peritoneal cavity.

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