Dialysis is a treatment that takes over the job of your kidneys if they fail. The kidneys have many functions that help your body stay healthy. They help clear toxins out of your blood and help your body balance salt levels. Most people begin dialysis when their kidneys have lost 85%-90% of their ability. You may be on dialysis for a short time, you may need it for the rest of your life, or until you receive a kidney transplant.
If you have kidneys that are not working and the damage is not reversible, you have end-stage renal disease (ESRD). ESRD is caused by conditions such as diabetes, kidney cancer, drug use, high blood pressure, or other kidney problems. Dialysis is not a cure for ESRD, but it does help you feel better and live longer.
There are 2 types of dialysis: hemodialysis and peritoneal dialysis. This fact sheet will focus on peritoneal dialysis.
Reasons for Procedure
The main functions of peritoneal dialysis are to:
- Remove waste and excess fluid from your blood
- Control blood pressure
- Keep a safe level of salts in the body, such as potassium, sodium, and chloride
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Anemia from a low red blood cell count
- Muscle cramps
- Nausea, vomiting
- Feeling hot, sweaty, weak, and/or lightheaded
- Infection of the abdominal cavity—peritonitis
- Inflammation of the heart sac—pericarditis
- Neurological problems
- Disruption of calcium and phosphorus balance, resulting in weakened bones
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
- Chronic diseases, such as diabetes or obesity
What to Expect
Prior to Procedure
Before the first treatment, a small, soft tube about 24 inches long will be placed in the abdomen. This tube will remain there permanently. A portion of the tube remains outside the body for use in the process. It is important to keep this access clean and dry to prevent infection.
Description of the Procedure
Peritoneal dialysis can often be done at home.
The abdominal lining is called the peritoneal membrane. It is used to filter blood. A cleansing solution, called a dialysate, is inserted into your abdominal cavity through a tube. Fluid, wastes, and chemicals pass from the tiny blood vessels in the peritoneal membrane into the dialysate. The dialysate is drained after several hours. New dialysate can be added to repeat the process.
There are 3 types of peritoneal dialysis:
- Continuous ambulatory peritoneal dialysis (CAPD)—This is the most common type of peritoneal dialysis. A bag of dialysate is infused into the abdomen through a tube called a catheter. It remains there for 3-6 hours and is drained. The abdomen is refilled with fresh solution. This way, your blood is always being cleaned.
- Continuous cyclical peritoneal dialysis (CCPD)—Infusing and refilling the abdomen with dialysate is done by machine. It is done at night while you are sleeping.
- Intermittent peritoneal dialysis (IPD)—This uses the same type of machine as CCPD. It requires assistance and is usually done at a hospital or center. It often takes longer than CCPD.
How Long Will It Take?
The time needed for peritoneal dialysis depends on a few factors:
- How much kidney function remains
- How much fluid weight gain has occurred since the last treatment
- Amount of waste in the body
- Body size
- Level of salts in your body, such as sodium, potassium, and chloride
- Peritoneal dialysis type used
The approximate time and frequency of each type:
|Type||Length of Procedure||Frequency of Procedure|
|CAPD||3-6 hours, plus 30 minutes to drain||4 times/day|
|CCPD||9-12 hours||Every night|
|IPD||12 + hours||36-42 hours/week|
Be sure to follow your doctor’s instructions. There are some special considerations.
Certain dietary guidelines should be followed. This will help to maintain overall health and optimize treatment effects. Talk to your doctor about your specific dietary needs.
Your doctor may give you various medications. These include, but are not limited to:
- Blood pressure medications
- Calcium supplements or multivitamins
- Phosphorus binders—to lower phosphorus levels in the blood
- Diuretics—to remove excess fluid
- Stool softeners or laxatives—to prevent or treat constipation, which can be caused by decreased fluid intake
- Iron supplements—to increase iron intake, which is important in the production of red blood cells
- Medications to stimulate the body to produce more red blood cells
Call Your Doctor
Contact your doctor if any of the following occur:
- Signs of infection, including fever and chills
- Redness, swelling, warmth, increasing pain, excessive bleeding, or discharge at the catheter or tube insertion site
- Blood or cloudiness in the peritoneal dialysis fluid
- Nausea or vomiting
- Abdominal pain
If you think you have an emergency, call for emergency medical services right away.
Kidney Dialysis Foundation
National Kidney Foundation
Kidney Foundation of Canada
Dialysis. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/dialysisinfo. Accessed June 1, 2016.
Peritoneal dialysis dose and adequacy. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/peritoneal-dialysis-dose-and-adequacy/Pages/facts.aspx. Updated September 2010. Accessed June 1, 2016.
Last reviewed June 2016 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.