Peritoneal dialysis is a treatment used to clean the blood of extra fluid and waste that builds up in the body when the kidneys do not work.

Catheter Placement and Care

A tube or catheter is placed through the abdominal muscles. One end is put into the peritoneal space. The peritoneal space is the empty space that surrounds the organs of the abdomen. 

The other end of the tube comes out of the abdomen about 6 inches. A large dressing will be over the catheter site to protect the site, promote healing and prevent infection. The staff will change the dressing about 5 days after surgery. Keep the dressing dry. 

The catheter is not used for 2 weeks after placement so the area can heal. If you need dialysis during this time, hemodialysis will be done.

How Peritoneal Dialysis Works

Continuous Ambulatory Peritoneal Dialysis (CAPD)

This 3-step process is called an exchange.

1. Fill

A bag of solution called dialysate is put into the abdomen through the catheter. This bag holds about 2 quarts of fluid. It takes about 10 to 20 minutes to fill. When the bag is empty, it can be clamped off or the tubing can be capped off.  

2. Dwell

The solution stays in the abdomen for 4 to 6 hours. While the solution is in the abdomen, extra fluid and wastes move from the blood and into the solution.

3. Drain

Using gravity, the solution is then drained out of the body into a drain bag. The drained fluid is much like urine and will be clear yellow. It takes about 10 to 20 minutes to drain. 

When the solution is drained, a new bag of dialysate is connected to the catheter and the steps are repeated. These 3 steps are done about 4 times each day with meals and at bedtime. Each cycle takes 20 to 40 minutes. 

After you are trained, you can do peritoneal dialysis anywhere there is a clean, private area. To prevent infection, the exchange must be done under clean conditions and the patient may need to wear gloves and a mask.

Continuous Cycling Peritoneal Dialysis (CCPD) 

With CCPD, there are fill, dwell and drain cycles, but the dwell time is shorter and a machine does the exchanges. The dwell time is about 1½ hours. The machine is set up and the person is connected to this machine for 8 to 10 hours during the night. The person is unhooked from the machine during the day. 

Call to the doctor when you have any of these signs of PD problems:  

1. Shortness of breath  
2. Swelling in the arms, legs, face or abdomen  
3. Extreme itching or bone pain, this can be a sign of too much phosphorus in the body  
4. Dizziness, nausea or cramping in the toes, feet or stomach  
5. Cloudy bags or drained dialysis solution is pink in color  
6. Redness, pain or swelling  
7. Leaking from the catheter site  
8. Catheter adapter or catheter falls out, or comes apart  
9. Hole in the catheter  
10. Changes in blood pressure