Peritoneal Dialysis (PD)
In peritoneal dialysis, your blood is filtered inside your own body instead of using a dialyzer machine. For this type of dialysis, the lining of your abdomen or belly area (also called the peritoneum) is used as a filter. Before starting peritoneal dialysis, a minor surgery is needed to place a catheter (soft tube) in your belly. During each treatment, your belly area is slowly filled with dialysate (a cleansing fluid made from a mixture of water, salt, and other additives) through the catheter. As your blood flows naturally through the area, extra fluid and waste products are pulled out of the blood vessels and into the belly area by the dialysate (almost like a magnet). After a few hours, the fluid mixture is drained from your belly using the same catheter and bag that was used at the beginning of the treatment. Peritoneal dialysis can be done almost anywhere if you have the supplies required to perform the treatment.
Two of the most common types of peritoneal dialysis are:
- Continuous Ambulatory Peritoneal Dialysis (CAPD)
- Automated Peritoneal Dialysis (APD)
The supplies and equipment needed, duration of each treatment (also known as an exchange), and number of treatments per day will differ depending on the type of PD you are using and your medical condition. More information about these treatments can be found on the NKF Peritoneal Dialysis AtoZ page.
Effectiveness
Dialysis is a very effective treatment option for clearing waste products and extra fluid from your blood. However, it does not fully replace all the kidney’s functions, so it is not considered a cure for kidney disease or kidney failure.
All types of dialysis are equally effective, but your medical condition and personal preferences may match one treatment approach better than others. You and your doctor will discuss this and decide which type of dialysis and which place is best. You may also find it helpful to talk with other people who are living with dialysis to learn from their experiences.
The following steps can help increase the effectiveness of your dialysis treatments:
- talk with your dialysis team about any concerns or side effects that you may have
- complete your treatments according to your prescribed schedule
- follow your customized eating plan recommended by your kidney dietitian
- get as much physical activity as possible to boost your strength and heart health
- talk with your dialysis provider and pharmacist about any medications, supplements, or herbal products you are taking or are considering starting
Side Effects
Both types of dialysis come with side effects. It can also be hard to tell for sure whether a symptom is because of the dialysis or the kidney failure that is also affecting the body. Some of the most common side effects that people report include:
- Hernia (weakness in your abdomen muscle, often presenting as a lump or swollen area)
- Weight gain
- Infection of the skin, blood, and/or peritoneum (belly area) – if left untreated, these can cause sepsis (a life-threatening condition leading to multiple organ failure).
- Fatigue (feeling tired) – This can affect anyone but is usually more common for people who have been on dialysis for a long time. It is often hard to tell for sure if this is a side effect of the dialysis or a symptom of long-term kidney disease.
- Pruritus– itchy skin that people with kidney disease may experience, especially in more advanced stages of CKD and people on dialysis. Like fatigue, it is often hard to tell for sure if this is a side effect of the dialysis or a symptom of long-term kidney disease.