PERITONEAL DIALYSIS

Peritoneal
dialysis uses a
natural filter inside
your body-the
lining of your belly,
called the
peritoneal
membrane-
to remove
wastes and extra fluid from your body. It also restores the normal balance of certain minerals in
the blood (electrolytes). The dialysis fluid fills the belly and pulls out extra minerals and fluids
from the bloodstream. These wastes then drain out of the body along with the dialysis fluid into
a collection bag. Peritoneal dialysis is usually done at home.

Introduction:
Though known since the 1940’s, peritoneal dialysis became a standard treatment used
in removing waste products from the body in 1976. An estimated 260,000 people in US suffer
from chronic renal (kidney) failure and 50,000 die each year from conditions secondary to this
disease.

On average, approximately one fifth- of the total of the total blood supply of the human
body- 1.3 qt (1.2L) of blood- passes through the kidneys every minute. Twelve times every hour,
the entire amount of blood present in the body circulates through the kidneys. Through an
osmotic process called glomerular filtration, selective fluids and dissolved chemicals are
filtered out, but necessary nutrients such as proteins are retained. The filtered-out solution
enters a part of the kidney called Bowman’s capsule, then passes through a system of tubes
that reabsorb nearly all (99%) of the fluid. The remaining 1% that contains the waste products
is sent down through two slender tubes, called ureters, to the bladder. From the bladder, the
urine created in the kidneys, on average 1.6 qt (1.5 L) is excreted.

Peritoneal dialysis is a method for removing waste such as urea and potassium from the
blood, as well as excess fluid, when the kidneys are incapable of this (i.e. in renal failure).

Peritoneal dialysis works on the principle that the peritoneal membrane that surrounds
the intestine, can act as a natural semipermeable membrane and that if a specially formulated
dialysis fluid is instilled around the membrane then dialysis occur, by diffusion. Excess fluid can
also be removed by osmosis, by altering the concentration of glucose in the fluid.

3 Types of peritoneal dialysis

Continuous ambulatory peritoneal dialysis (CAPD) - the most common type, needs no
machine and can be done at home. Exchanges of fluid are done throughout the day, usually
four exchanges a day. During CAPD, the dialysate solution stays in your belly for about 4 to 6
hours. After this time, the solution is drained out of your belly. Your belly is then refilled with
fresh solution. You need to change the solution about 4 times
a day. This is the most commonly used form of peritoneal
dialysis.

Continuous cyclic peritoneal dialysis (CCPD) - uses a

machine and is usually performed at night when the person is
sleeping. During CCPD, a machine automatically fills and
drains the dialysate from your belly. This process takes about
10 to 12 hours, so you can perform CCPD at night while you
sleep.
• Portable—do it anywhere
• Convenient—have your days free
• Easy—learn it in a week or two
• No needles—avoid needle sticks
• Less restrictive—easier diet
• Routine—feel healthy, not sick
• Time—fewer trips to the clinic

Intermittent peritoneal dialysis- uses the same type of machine as CCPD. It is usually
performed in the hospital. Treatment sessions may last up to 24 hours and are done several
times a week.IPD is rarely done anymore.

PURPOSE:
• To remove waste as urea and potassium from blood
• To remove excess fluid, when the kidneys are incapable of this (i.e. in renal failure)
• Remove wastes and extra fluid from your body
• It stores the normal balance of certain minerals in the blood (electrolytes).
• The dialysis fluid fills the belly and pulls out extra minerals and fluids from the blood
stream. These wastes then drain out the body along with the dialysis fluid into a
collection bag.

INDICATIONS:
Laboratory results which suggest PD:
• Serum Creatinine- 10 mg/100 ml
• BUN- more than 100 mg/ 100 ml
• K+- more than 6 meq/L
• CRF

Contraindications
• Scarring of the lining of the abdominal wall (peritoneal membrane)
• Leaks in the lining of the abdominal wall
• Active IBD (Crohn's disease, ulcerative colitis)

Reported by: Passed to:

Rovefrances Erpelua Ms. Shiela Ritas