Peritoneal dialysis
peritoneal-dialysis (PD)

When a patient of chronic kidney disease (CKD) progress from CKD stage 1 to CKD stage 5 then patient needs dialysis other than medicines. Dialysis is a way to remove waste products from the blood when kidneys fail to perform their job adequately.

Under this, the blood is filtered differently than the common blood-filtering procedures.

There are 2 types of dialysis hemodialysis and peritoneal dialysis. During this, a cleansing fluid runs through a tube into a part of your abdomen.

The lining of the abdomen, named the peritoneum, acts as a filter and removes waste products from the blood. After a fixed time, the fluid with the filtered waste products flows out of the abdomen and is discarded.

Why is it required?

There is a need for peritoneal dialysis when kidneys no longer work well. 

Ideal for patients who:

  • Cannot bear the rapid changes of fluid balance associated with hemodialysis
  • Want to minimize the disturbance of your daily activities
  • Wish to travel and work more easily

What are the benefits?

The benefits of peritoneal dialysis include:

  • Lifestyle flexibility and independence– this point is great if you have a problem with going to a hemodialysis center.
  • Less restricted diet- peritoneal dialysis is done more frequently, which results in less accumulation of potassium, sodium, and fluids. This allows the patient to have an intake of a flexible diet.
  • Long-lasting residual kidney function– people who go through peritoneal dialysis retain kidney function slighter longer than people who use the other type of dialysis.
  • Needle-free treatments– under this type of dialysis, the patient faces less experience with needles, which means less or no pain.

For whom it may not work?

Peritoneal dialysis will not work for those who have:

  • Surgical scars inside their abdomen
  • A large area of weak abdominal muscle (hernia)
  • Limited potential to take care of themselves or lack of caregiving support
  • Inflammatory bowel disease

Risks 

Complications of this dialysis include:

Restrictions during peritoneal dialysis 

You need to avoid the following things:

  • Specific prescriptions and over-the-counter medicines that can cause serious damage to your kidneys, including nonsteroidal anti-inflammatory drugs.
  • Soaking in the bathtub, swimming in a lake, pond, or non-chlorinated pool, which can increase the risk of infection. Swimming in a chlorinated pool is not a problem.

How to get prepared?

You will be required to go through an operation for inserting the catheter that carries the cleansing fluid in and out of the abdomen. The insertion is done generally using local or general anaesthesia. The tube is inserted by the doctor near the belly button.

After inserting the tube, the doctor recommends waiting up to 10 to 14 days before starting the peritoneal dialysis. This is recommended so that the catheter site gets time to heal. Moreover, you will receive training on how to use the peritoneal dialysis treatment.

Results 

Many factors contribute to the removal of wastes and extra fluid from the body.

  • Size of the body 
  • Amount of dialysis solution used by the patient 
  • The number of daily exchanges 
  • Length of dwell times 
  • The presence of sugar in the dialysis solution

To check the results of dialysis, the doctor will possibly recommend the following tests:

  • Peritoneal equilibration test– the test compares the sample of blood and dialysis solution during the exchange. The test indicates whether the waste is being passed quickly or slowly from the blood into the dialysate.
  • Clearance test– samples of blood and used dialysis solution are analyzed to determine how much waste is being removed from the blood during dialysis.

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