About Peritoneal Dialysis
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Why do I need peritoneal
dialysis?
Peritoneal dialysis is for people who are very
young, very old, or very sick. During hemodialysis,
blood pressure and electrolytes can change rapidly,
which can be dangerous for people whose body cannot
tolerate these sudden changes. People who bleed
easily, and who have diabetes, are also recommended
for peritoneal dialysis, which does not use blood
thinners or sugars in the dialysate solution.
People who have scars or leaks in the lining
of their abdominal wall, or who have inflammatory
bowel disease, cannot use peritoneal dialysis.
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How do I know which
type of peritoneal dialysis is right for me?
The best type of peritoneal dialysis for you depends
on a number of factors, including your health
history. Your doctor will recommend one of three
types of peritoneal dialysis for you.
Continuous ambulatory peritoneal dialysis
(CAPD) is the most common type of peritoneal dialysis.
In CAPD a solution from a plastic bag enters the
abdomen through a catheter. After about four to
six hours the solution is drained out of the abdomen
back into the bag, and replaced with fresh solution.
This cycle repeats about four times per day.
Continuous cycling peritoneal dialysis
(CCPD) is a continuous procedure where a machine
automatically fills and drains the dialysis solution
from the abdomen. CCPD takes about 10 to 12 hours,
and can be done at night while sleeping.
Like CCPD, intermittent peritoneal dialysis
(IPD) uses a machine to fill and empty the abdomen
of solution, but it takes about 24 hours. This
type of peritoneal dialysis can be done at home
but is usually done in a hospital.
You should discuss your peritoneal dialysis options
with your doctor. Some questions to ask:
- Am I a candidate for continuous ambulatory
peritoneal dialysis?
- What are the risks and benefits of the type
of peritoneal dialysis prescribed for me?
- Is it likely that I will have catheter problems,
or need my peritoneal catheter replaced?
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What is a peritoneal
catheter?
Before you can begin peritoneal dialysis, you
must have a special tube (catheter) placed in
your abdomen so that dialysate solution can flow
into and out of your abdominal cavity. If possible,
the catheter should be placed at least 10 to 14
days before dialysis starts. Catheters often last
for about three years before they need to be replaced.
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What is peritoneal dialysis
catheter manipulation?
Peritoneal dialysis is performed through a tube
passing through the abdominal wall into the abdominal
cavity. Occasionally, when this tube becomes blocked
or malfunctions, an interventional radiologist
can reposition the tube to restore function, without
removing or replacing the tube. In this outpatient
procedure, a wire is passed through the tube under
X-ray guidance and the tube repositioned into
a better location within the abdomen. The procedure
typically takes less than an hour and the patient
can return to peritoneal dialysis immediately.
Catheter manipulation can be repeated in the future
if necessary.
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Are there any risks
of peritoneal dialysis?
There is a risk of complications associated with
peritoneal dialysis. These include inflammation
of the lining of the abdominal wall (peritonitis),
catheter tube infection, and increased abdominal
pressure that may cause a hernia. When you get
your catheter, you will learn about the warning
signs of inflammation, infection and increased
abdominal pressure due to peritoneal dialysis.
Screening tests at the Dialysis Unit and regular
self-examination of your catheter will help detect
problems caused by your peritoneal dialysis.
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Reviewed by:
Scott Trerotola, MD
January, 2003
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