Peritoneal dialysis how does it work

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 belly. Different solutions have different strengths of dextrose or icodextrin. Your doctor will prescribe a formula that fits your needs. In automated peritoneal dialysis, you use a machine called a cycler to fill and drain your belly. You can program the cycler to give you different amounts of dialysis solution at different times.

Each evening, you set up the machine to do three to five exchanges for you. You connect three to five bags of dialysis solution to tubing that goes into the cycler—one bag of solution for each exchange.

The machine may have a special tube to connect the bag for the last exchange of the night. A fluid meter in the cycler measures and records how much solution the cycler removes. Some cyclers compare the amount that was put in with the amount that drains out.

This feature lets you and your doctor know if the treatment is removing enough fluid from your body. Some cyclers allow you to use a long drain line that drains directly into your toilet or bathtub. Others have a disposal container. Your schedule will change as you work your dialysis exchanges into your routine. If you do CAPD during the day, you have some control over when you do the exchanges. You may need to limit some physical activities when your belly is full of dialysis solution.

You may still be active and play sports, but you should discuss your activities with your health care team. Adjusting to the effects of kidney failure and the time you spend on dialysis can be hard for both you and your family. You may. A counselor or social worker can answer your questions and help you cope.

Your health care team will show you how to keep your catheter clean to prevent infections. Here are some general rules:. Possible problems from peritoneal dialysis include infection, hernia , and weight gain. One of the most serious problems related to peritoneal dialysis is infection. You can get an infection of the skin around your catheter exit site or you can develop peritonitis, an infection in the fluid in your belly.

Bacteria can enter your body through your catheter as you connect or disconnect it from the bags. Signs of an exit site infection include redness, pus , swelling or bulging, and tenderness or pain at the exit site. Health care professionals treat infections at the exit site with antibiotics. Health care professionals treat peritonitis with antibiotics.

Antibiotics are added to the dialysis solution that you can usually take at home. Quick treatment may prevent additional problems. Peritoneal dialysis increases your risk for a hernia for a couple of reasons. First, you have an opening in your muscle for your catheter. Second, the weight of the dialysis solution within your belly puts pressure on your muscle. Hernias can occur near your belly button, near the exit site, or in your groin.

If you have a swelling or new lump in your groin or belly, talk with your health care professional. The longer the dialysis solution remains in your belly, the more dextrose your body will absorb from the dialysis solution. This can cause weight gain over time. With CAPD, 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 cycler 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 to remove more wastes and extra fluid from your body. These tests help your doctor prescribe a dialysis schedule and dose to meet your health needs.

Read about peritoneal dialysis dose and adequacy. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Kidney Failure What is Kidney Failure? What are the types of peritoneal dialysis? Where can I do peritoneal dialysis? It can act as an artificial kidney and help rid the body of waste products while maintaining fluid balance.

A few weeks later, a person will put a special solution called dialysate into the belly through the catheter. When this is done, a person can disconnect the bag, place a cap on the catheter, and resume normal activities. After a few hours, they use the catheter to drain the fluid. This is called an exchange. The process should not cause pain. People can expect to feel normal or bloated when the solution is in the belly. The National Kidney Foundation state that there are two types of peritoneal dialysis.

One type is called continuous ambulatory peritoneal dialysis CAPD. This is a continuous and machine-free method. A person will place two quarts of the fluid into the belly and drain it later. They will need to do this 4—5 times over 24 hours.

Each exchange can take 30—40 minutes. Another type is called automated peritoneal dialysis APD. This involves attaching the dialysis catheter to an automated machine that will exchange the dialysis solution while a person sleeps.

Another name for this approach is continuous cycling peritoneal dialysis, or CCPD. A person can discuss their options with a healthcare professional to decide which method is best for them. Some people prefer a doctor place the catheter under general anesthesia where a person is asleep and unaware of the procedure. A doctor will usually recommend that a person not eat or drink anything after midnight before getting a peritoneal dialysis catheter. This is especially true if the person is going under general anesthesia for the catheter placement.

They should talk to a healthcare professional about the materials they will need to care for the catheter insertion site. The NIDDK notes that, if possible, a person should plan to have this procedure 3 weeks before the first exchange, and the catheter will work better if it has approximately 10—20 days to heal before the first use. A person will need to undergo training to perform either type of peritoneal dialysis at home. A dialysis nurse will train a person for 1—2 weeks.

They will learn how to prepare the cycler, place the drain tube, and connect the dialysis bags. Even if a person uses APD, they must learn how to perform exchanges without a machine in case a power outage or machine failure occurs.

Infection prevention is very important in peritoneal dialysis, so a person using it must train well in sterile measures. To perform an exchange, a person should wash their hands thoroughly and use a face mask before accessing the dialysis catheter. They should then use a special connector called a transfer set to act as a connection between the catheter and the dialysis bag. To perform a hand exchange, a person will need to warm the dialysis bag up to body temperature.

A person can do this:. They should then hang the bag on a pole and connect it to the transfer tubing to allow the solution to enter their body. If they are using APD, the machine will warm the bag. A person can program the machine to deliver a certain amount of cycles at night.

The membranes filter waste products from your blood, which are passed into the dialysate fluid. The used dialysate fluid is pumped out of the dialyser, and the filtered blood is passed back into your body through the second needle. During your dialysis sessions, you'll sit or lie on a couch, recliner or bed. You'll be able to read, listen to music, use your mobile phone or sleep.

Haemodialysis is not painful, but you may feel a bit sick and dizzy and have muscle cramps during the procedure. This is caused by the rapid changes in blood fluid levels that happen during the treatment. After the dialysis session, the needles are removed and a plaster is applied to prevent bleeding.

If you were treated in hospital, you can usually go home shortly afterwards. If you're having haemodialysis, the amount of fluid you can drink will be severely restricted. This is because the dialysis machine will not be able to remove 2 to 3 days' worth of excess fluid from your blood in 4 hours if you drink too much.

This can lead to serious problems where excess fluid builds up in your blood, tissues and lungs. The amount of fluid you're allowed to drink will depend on your size and weight. Most people are only allowed to drink 1, to 1,ml 2 to 3 pints of fluid a day. You'll also need to be careful what you eat while having haemodialysis.

This is because minerals such as sodium salt , potassium and phosphorus, which would normally be filtered out by your kidneys, can build up to dangerous levels quickly between treatment sessions. You'll be referred to a dietitian so a suitable diet plan can be drawn up for you. Diet plans differ from person to person, but it's likely you'll be advised to avoid eating foods high in potassium and phosphorus, and cut down the amount of salt you eat.

Both treatments can be done at home once you've been trained to carry them out yourself. This will allow the dialysis fluid dialysate to be pumped into the space inside your abdomen the peritoneal cavity.

A cut incision is usually made just below your belly button. A thin tube called a catheter is inserted into the incision and the opening will normally be left to heal for a few weeks before treatment starts. The catheter is permanently attached to your abdomen, which some people find difficult. If you're unable to get used to the catheter, you can have it removed and switch to haemodialysis instead. At first, the bag containing dialysate fluid is attached to the catheter in your abdomen.