Your guide to the world for dialysis


Peritoneal dialysis

Peritoneal dialysis is a method that lets patients suffering from chronic renal failure survive. A treatment involving peritoneal dialyses is a solution that makes it possible to provide a renal replacement therapy using the abdominal cavity. To purify the blood of waste substances and excess water, contemporary medicine uses the peritoneal membrane lining the abdominal cavity on the inside.


Peritoneum is about 2 square metres of a well vascularised, thin membrane which shields and covers the walls and all internal organs in the abdomen. Its main advantage is its permeability to water and many other substances which can freely move back and forth between blood and the peritoneal cavity fluid. Before a therapy using this method is commenced, an appropriate catheter in the form of a soft, flexible tube must be inserted in the body. It is implanted in the peritoneal cavity as follows: the tip of the catheter is placed at the bottom of the cavity, then the catheter is guided under the skin of the abdomen, and the tip goes outside. The catheter is used first and foremost to let the dialysis fluid in and out. It is important that the catheter be implanted no later than two months before the planned commencement of the treatment.


The very process of performing a dialysis involves introducing the dialysis fluid into the abdominal cavity, and letting it out after a certain time. It is a cycle repeated at previously planned intervals. The liquid, with specifically selected chemical properties, lets the harmful substances from blood (such as urea, potassium, phosphates and other) permeate it, as well as allowing blood to absorb the substances necessary to balance acidosis.


Peritoneal dialysis and the treatment that uses this method usually take place at the patient’s home. In such a case, a specially isolated room is essential since sterility must be ensured for exchanges of the dialysis fluid. Depending on the patient’s health, age and lifestyle, peritoneal dialysis can be performed in two ways:


  • CAPD (Continuous Ambulatory Peritoneal Dialysis) – used since 1976, recommended mostly to patients who are just beginning the dialysis system and require less dialysis fluid, and who have the time and the right conditions for dialyses 3-4 times a day at their homes.
  • APD (Automated Peritoneal Dialysis) – recommended especially to patients who need more dialysis fluid or those who require more frequent fluid exchanges. This method is also used in the case of professionally active people who do not have too much free time, which is required to perform dialysis during the day, and to the disabled and young people. APD involves exchanging the dialysis fluid while the patient is asleep. A special machine is used for this purpose, known as cycler.


Advantages of peritoneal dialysis include:


  • stability of the cardiovascular system – hyperkalaemia, pressure drops and overhydration are observed more rarely,
  • anaemia is less intensive, which considerably eliminates treatment with erythropoietin,
  • only sporadic itching of the skin,
  • even adjustment of acidosis,
  • less restrictive diet within water and potassium metabolism,
  • better comfort of life for the patient,
  • a dialysis treatment takes place at the patient’s home; follow-up at a dialysis centre every 4-6 weeks, or earlier in the event of complications,


Just like the whole related treatment system, peritoneal dialysis is painless. Sometimes there may be complications in the form of an infection in the area of the catheter or peritonitis. Treatment in such cases involves mostly administering the right antibiotics to the patient. However, sometimes the catheter needs to be removed and a therapy known as haemodialysis must be applied. Other conditions that may occur in a dialysed patient include abdominal hernia, leaks of dialysis fluid or common lumbar pains.


Treatment using peritoneal dialyses is not a sentence. On the contrary: in spite of appearances, patients treated via the peritoneal cavity remain able to work and exercise, they can also travel – even though it entails the need to take the required items and equipment with them – and women can get pregnant. This method is of course very time-consuming but it enables people to fully enjoy life.

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