Peritoneal Dialysis

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Peritoneal Dialysis

Peritoneal Dialysis is a procedure for the removal of waste products from the blood when the kidneys fail to function properly. The procedure allows filtering the blood in a way different than the hemodialysis or blood-filtering procedure.

During this procedure, a cleansing fluid will flow through the catheter (a tube) into a part of the abdomen. The peritoneum (lining of the abdomen) will act as a filter to remove all the waste products from your blood.

After a certain time, the fluid along with the filtered waste products will flow out from your abdomen. The doctor will discard this fluid. Although you can do these treatments at home or even during traveling, it is not the right option for everyone having kidney failure.

Why do I need to undergo this procedure?

You need to go for this procedure if your kidneys are not functioning properly any longer. Damage to the kidneys usually advances due to long-term conditions over the years. These conditions may be:

  • High blood pressure
  • Polycystic kidney disease (a disease in which there are multiple cysts in the kidneys)
  • Diabetes
  • Glomerulonephritis or inflammation of the kidneys

 

Although both- Peritoneal Dialysis and hemodialysis can filter your blood in an effective way, Peritoneal dialysis has far-fetching benefits.

  • It allows lifestyle flexibility as you can perform dialysis anywhere. If you are working, traveling, or are at a place that is far from the hemodialysis center, you can perform Peritoneal Dialysis easily.
  • There is less accumulation of fluids, potassium, and sodium as you need to do this dialysis more continuously. Ultimately, you can have a diet more flexible than the diet during hemodialysis.
  • It allows you to retain kidney functions longer than hemodialysis.

 

You might consider certain factors to decide which type of dialysis is good for you. These factors must include your overall health, your home environment, your kidney function, your lifestyle, and your personal choices. The peritoneal procedure is the right option for you if you have some kidney function, want to minimize disturbance to your daily activities, want flexibility in working or traveling, and are intolerant to rapid changes in a fluid balance that associates with hemodialysis.

How to prepare?

You might need to undergo an operation for the insertion of the tube carrying dialysate in your abdomen. Your doctor will insert this tube after administering local or general anesthesia to you. The insertion of the tube will be near your belly button. After the insertion of the tube, your doctor will suggest you wait for a month before starting the treatment of Peritoneal Dialysis so that the site of insertion of the catheter will heal with time.

What to expect?

The dialysate will flow into your abdomen during the procedure and will be there for around 6 hours. This is the dwell time of the dialysate. The dextrose present in it helps to filter the chemicals, waste, and fluids present in your blood from the blood vessels of your abdominal cavity lining. The solution containing the waste products drawn from the blood will be drained into the collection bag after the dwell time gets over. This entire process of filling & draining is known as an exchange. The schedule of exchange varies for each method of Peritoneal Dialysis which are:

Continuous ambulatory peritoneal dialysis

In this, your abdomen will be filled with dialysate and remain there till the dwell time gets over. After this, the doctor will drain the fluid. You might need around 5 exchanges in the day time and an exchange with a longer dwell time at the time of sleeping. You may do the exchanges anywhere at a clean place. With the dialysate dwelling in your abdomen, you can perform all your routine activities.

Continuous cycling peritoneal dialysis

The other name for this is Automated Peritoneal Dialysis. It makes use of an automated cycler (a machine) that can perform multiple exchanges during the night time when you are asleep. It automatically fills dialysate into your abdomen, allows it to dwell, and then drains into a fresh bag that you can empty later in the morning. However, you need to be attached to the machine for nearly 12 hours at night. There is a lower risk of peritonitis.

Results

The factors determining the working of Peritoneal Dialysis for waste & extra fluid removal from your blood are:

  • How quick your peritoneum is in filtering the waste
  • The number of exchanges each day
  • Sugar concentration in the dialysis solution
  • Your size
  • Quantity of dialysis solution you are using
  • The length of the dwell time.

Risks

The most common complications of the Peritoneal Dialysis include:

  • Infection of the lining of your abdomen (peritonitis)
  • Weight gain
  • Hernia due to holding of fluids longer in your abdomen
  • Inadequate dialysis

 

Your doctor might recommend some tests to check whether your dialysis is effectively removing the wastes or not. These tests may be Peritoneal equilibration test (PET) or clearance test. If the results are not up to the mark, your doctor will either increase your number of exchanges, use a dialysate that contains a higher concentration of dextrose, or increase your amount of dialysate. You can eat the right foods to get better results and improved overall health. Also, ensure that you regularly take your medications.

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