Peritoneal Dialysis

Peritoneal dialysis (PD) is the most preferred choice among home dialysis treatment options; Malaysia has now opted for PD First Policy.  You can give yourself treatments at home, at work or while traveling, while on peritoneal dialysis. With PD, you may be able to use fewer medications and eat a less restrictive diet compared with hemodialysis treatment. You will need to have a PD catheter (also called Tenckhoff catheter) placed in your belly (dialysis access) before you begin dialysis. Placement is usually done 10 to 14 days before dialysis starts. 

Peritoneal dialysis (PD) is a dialysis treatment that uses the thin membrane (called the peritoneum) that lines the abdomen to perform dialysis treatments. During treatments, a fluid called dialysate is put into the abdomen through a small, flexible tube called a PD catheter.

The dialysate pulls waste and extra fluid from the blood into the peritoneal cavity. The dialysate remains in the abdomen for a specified amount of time before it is drained and replaced with fresh dialysate. When the dialysate is drained, the wastes and extra fluids are also drained, and fresh dialysate is instilled to clean the blood. This filling, dwelling and draining process is called an exchange and takes about 30 to 40 minutes. The fill and drain phases of the exchanges can be done manually or with a machine called a cycler.

In order to perform PD, you will need to have a PD catheter placed into your abdomen. A PD catheter is a flexible plastic tube that allows dialysis fluid to enter the abdominal cavity, dwell inside for a while, and then drain back out again. PD catheter placement is considered a minor operation, and complications are rare. It often requires general anesthesia, but the whole procedure takes less than one hour of surgical time. Most catheters have two Dacron cuffs that remain inside the abdominal wall to keep it in place.

1. Fill : Dialysis fluids enters your peritoneal cavity

2. Dwell : While the fluids is in your peritoneal cavity, extra fluid and waste travel across the peritoneal                                 membrane into the dialysis fluid

3. Drain : After the specified dwell time, the dialysis fluid is drained and replaced with new fluid

 

TYPES OF PERITONEAL DIALYSIS

1.  Automated Peritoneal Dialysis (APD)

With APD, which may also be called Continuous Cycling Peritoneal Dialysis (CCPD), a machine called an automated cycler performs three to five exchanges at night while you sleep. The cycler automatically fills your abdomen with dialysis solution, allows it to dwell there and then drains it to a sterile drainage bag that you empty in the morning. This gives you more flexibility during the day, but you must remain attached to the machine for 10 to 12 hours at night. In the morning, you begin one exchange with a dwell time that lasts the entire day, if required. You are not connected to the machine during the day.


APD Modality 

 

 

 

 

 

 

 

 

 

 

 

 

The new INTELLIS by Lucenxia is an Automated Peritoneal Dialysis (APD) system that has been designed to meet the needs of many patients, including children and adults of different weights and sizes. 

 

 

2.  Continuous Ambulatory Peritoneal Dialysis (CAPD)


 

With CAPD, you will drain a fresh bag of dialysis solution into your abdomen manually. After 4 to 6 or more hours of dwell time, you will drain the solution, which now contains wastes, into the bag. You then repeat the next cycle with a fresh bag of solution. You do not need a machine for CAPD; all you need is gravity to fill and empty your abdomen. Your doctor will prescribe the number of exchanges you will need, typically three or four exchanges during the day and one evening exchange with a long overnight dwell time while you sleep.



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