Did you know that there are two types of dialysis? We’ve discussed hemodialysis at length, so today we’d like to focus on peritoneal dialysis. Before we look at the pros and cons of peritoneal dialysis (PD), let’s first understand what this type of dialysis is all about!
Each of us has a natural lining that protects the organs inside our abdominal cavity. This lining, called the peritoneal membrane, can substitute and function as a filter when our kidneys are not able to function properly. In order to use the peritoneal membrane this way, your doctor needs to do some prep work to gain access. Understanding how this process works will give you a better understanding of the pros and cons of peritoneal dialysis.
How Peritoneal Dialysis Works
To begin peritoneal dialysis, a catheter is surgically placed in your abdominal cavity to be used something called an ‘exchange’. Fluid is put into the abdominal cavity, we let it sit there for a few hours, and then we drain it. With the drain comes excess water and waste products.
There are two kinds of peritoneal dialysis:
- Continuous Ambulatory PD (CAPD)
- Automated PD (APD)
The basic treatment is the same for each. However, the number of treatments and the way the treatments are done make each PD method different.
First Option: Continuous Ambulatory PD
CAPD is “machine-free” or “manual” PD, meaning you perform the process yourself.
Continuous: Done while you go about your normal activities
Ambulatory: Done in different places, i.e. work, school, or travelling
You do the CAPD treatment by placing about two quarts of cleansing fluid into your belly and later draining it.
This is done by hooking up a plastic bag of cleansing fluid to the tube in your belly. Raising the plastic bag to shoulder level causes gravity to pull the fluid into your belly. When empty, the plastic bag is removed and thrown away.
Finishing the Exchange
When the exchange (putting in and taking out the fluid) finishes, the fluid which now contains wastes removed from your blood drains from your belly into a separate bag. PD patients then throw this fluid away. This whole process usually is done three, four or five times in a 24-hour period while you are awake during normal activities.
Second Option: Automatic PD
APD differs from CAPD in that a machine, called a cycler, delivers and then drains the cleansing fluid for you.
Automatic: Done with the assistance of a machine
APD patients typically do their treatments at night while sleeping. A cycler machine will be provided to you by your dialysis unit to take home. Most people who choose APD set up their cycler machines by the bed for easy access.
Pros of Peritoneal Dialysis
Some doctors feel that PD has several benefits when compared to hemodialysis. Here are some of the pros of peritoneal dialysis:
- With continuous dialysis, you can control extra fluid more easily, and this may reduce stress on the heart and blood vessels.
- You are able to eat more
- It usually requires fewer medications.
- You’ll enjoy better quality of life. You can do more of your daily activities, and it is easier to work or travel.
Cons of Peritoneal Dialysis
There are a few drawbacks to PD treatment. Patients who are obese or have multiple prior abdominal surgeries may not be good candidates. The main con of peritoneal dialysis is the risk of peritonitis. This infection of the abdomen is an occasional complication, although should be infrequent with appropriate precautions. Your nurse will go over these precautions with you beforehand.
Considering Individual Circumstances
The best way to understand the pros and cons of peritoneal dialysis is to discuss treatment options with your doctor. Every person’s circumstances and health are different, so what’s good for one person is not necessarily the best choice for someone else!
Questions about the Pros and Cons of Peritoneal Dialysis
Peritoneal dialysis serves as an effective form of dialysis, and it offers an equally effective alternative to hemodialysis. PD patients work very closely with the nurses and go through a training process to make sure that they perform the steps correctly. If you are seeking a nephrologist to make recommendations for dialysis in the Orange County area, Dr. Gandotra is accepting new patients: (714) 435-0150