How does peritoneal Dialysis work ?
4 soft catheter (tube) is placed in the belly surgically. Special fluid is put in belly through this tube for specific time duration which is usually in minutes to hours this fluid is drained manually or automatically once the filtration process is complete.
What are the types of peritoneal Dialysis
1. Continous ambulatory peritoneal Dialysis (CAPD)
2. Automated peritoneal Dialysis (APD)
The basic principle is same for both, however the number of treatments and the way the treatments are done make each method different.
As the name suggest ‘CAPD’ is continuous process and at the same timeit keeps the patient ambulatory or mobile.
In this the special fluid is put in the belly via the tube. There are different types of fluids as per the need of patient and about 1.5 litre to 2 litre fluid is put in the belly. This is done by hooking up a plastic bag of cleansing fluid into the tube in your belly. Raising the plastic bag to the height above the belly level causes gravity to pull the fluid in belly more effectively.
This can be done by the trained family members or the patient self. Once the fluid is in, patient (tube) is disconnected from the fluid bag and the patient is free to carry out his/her daily activities. This cycle is repeated 3-4 times in 24 hours each cycle is usually of 6-8 hours. Each exchange takes about 30-40 mins.
During each cycle the belly fluid of previous cycle is drained out in the others plastic bag and declared. This drained fluid quantity is more than the entered fluid as it is a collection of excess water and also has a waste material and toxins.
APD( Automated peritoreal Dialysis) as the name suggest is automated or done with the machine. The exchanges which are done manually in CAPD are done with the help of a machine called ‘cycler’. This is done at night when patient sleeps . with multiple automatic exchanges so that the patient remains fluid free during day time.
The selection depends on the patient's choice, medical condition and other associated factor.
Complications of peritoreal Dialysis
Peritonitis or abdominal infection is infrequent complication and can be avoided with appropriate aseptic precaution infection at the tube site ( site infection)
Uncontrolled fluid removal
Uncontrolled electrolyte removal
They can be corrected and avoided with regular monitoring and appropriate precaution.
Benefits of peritoneal dialysis
1. No vascular access or needling is required
2. It is a home based therapy so transportation is not needed More flexible suits better into regular life style.
3. Patient is involved more actively in the treatment.
4. AD is slow process which mimics the function of real kidneys.