Do you know what peritoneal dialysis (PD) is? Many CKD patients are more familiar with hemodialysis (HD), however, PD can be a more comfortable and less time-consuming option. Learn more about PD, including how it works, the types of PD options, the pros and cons, and the qualifications.* 

How does PD work?

Within the abdomen is a lining of tissue called the peritoneum (per-uh-TOE-nee-um), that protects and supports the organs. PD treatments use a cleansing fluid, or dialysate, that is inserted into the abdomen with a thin, flexible tube, also known as a PD catheter. This process of inserting fluid into the abdomen can either be done by the patient or with a machine.

Once the dialysate is inserted in the abdomen, it stays for a set amount of time, which is prescribed by a physician. This time is called “dwell time.” During the dwell time, extra waste and fluid are pulled from the blood vessels into the open space inside the peritoneum called the “peritoneal cavity.” 

When the dwell time is complete, the patient (either manually or using a PD machine) empties the waste fluid from the peritoneal cavity into a drainage bag. This filling and draining process is known as an exchange or cycle. 

What are the types of PD?

There are two types of PD available to patients, which may be chosen based on lifestyle and level of comfort in performing medical care. 

Exchanges in continuous ambulatory peritoneal dialysis (CAPD) are done manually by a patient, and are usually completed multiple times throughout the day and once at night. It can be done at home, at work, or in any clean area. During the dwell time, patients are able to move around and conduct their normal activities.

Continuous cycling peritoneal dialysis (CCPD) is performed by a machine, or cycler, and is mainly done at night while a patient sleeps. The cycler will perform three to five exchanges during the night. In the morning, a patient begins one exchange with a dwell time that lasts the entire day. 

What are the advantages?

PD is preferred by many dialysis patients because of these benefits:

• Fewer side effects than HD, including nausea, vomiting, and cramping
• Provides daily and continuous therapy
• Usually allows for fewer dietary restrictions
• Needle-free treatments
• PD supplies are shipped directly to your home or travel destination
• Do not have to go to dialysis centers for treatment
• More flexibility and freedom

What are the disadvantages?

The disadvantages to PD include:

Must incorporate dialysis into your daily routine

• Need a permanent catheter, outside the body
• Increased risk for peritonitis, infection of the peritoneum 
• Have a larger waistline from dialysis fluid inserted in the abdomen
• Need storage space for PD supplies at your home
• Need space in your bedroom for a PD machine and equipment
• Requires more responsibility and training 

What do I need to know before starting PD?

Once you and your doctor discuss your dialysis options and decide on PD, you will have a surgical procedure to insert the peritoneal catheter. Following the procedure, you will meet and receive training from your dialysis healthcare team members, which consists of a dialysis nurse, registered dietitian, and social worker. You are encouraged to have a trusted family member or friend be there during training to help provide support.

If you are interested in PD, speak with your doctor to learn about the qualifications and see if you are a good candidate. 

*NephCure Kidney International. (2015, November 11). Peritoneal Dialysis. https://nephcure.org/peritoneal-dialysis/

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