Peritoneal Dialysis (PD) is a type of dialysis used to remove waste products and excess fluid from the blood when the kidneys are not functioning properly (end-stage renal disease). It uses the lining of your abdomen (peritoneum) as a natural filter.

🧬 What is Peritoneal Dialysis?

⚙️ How It Works:

A sterile dialysis solution (dialysate) is introduced into the peritoneal cavity through a catheter. The peritoneal membrane acts as a semi-permeable barrier. Waste products and excess electrolytes from blood vessels in the peritoneum diffuse into the dialysate. After a set dwell time, the fluid (now containing waste) is drained out.

📌 Types of Peritoneal Dialysis:

1. Continuous Ambulatory Peritoneal Dialysis (CAPD)

Manual exchange done 4–5 times a day
Each exchange lasts 30–40 minutes
No machine required

2. Automated Peritoneal Dialysis (APD) / Continuous Cycler-Assisted PD (CCPD)

Machine (cycler) performs exchanges overnight while patient sleeps
Typically 8–10 hours per night

🔄 The PD Cycle:

Fill – Dialysate is infused into the peritoneal cavity (~1.5 to 3 L)
Dwell – Solution remains in the abdomen for several hours, allowing exchange of solutes
Drain – Used solution is drained and replaced with fresh dialysate

💉 Catheter Placement:

Done surgically (usually under local or general anesthesia)
A Tenckhoff catheter is placed into the peritoneal cavity
Heals over a few weeks before use

📊 Indications:

Chronic Kidney Disease (CKD) Stage 5 / End-Stage Renal Disease (ESRD)
Preference for home-based therapy
Patients with vascular access issues (where hemodialysis is difficult)

❌ Contraindications:

Extensive abdominal surgery/scarring
Hernias
Inflammatory bowel disease
Severe obesity (relative)
Lack of home support or patient compliance

🔍 Advantages of PD:

✅ Can be done at home

✅ No needles

✅ More stable fluid/electrolyte balance

✅ Better preservation of residual kidney function

✅ Greater flexibility and mobility

✅ Gentle on the heart (better for cardiac patients)

❌ Disadvantages of PD:

⛔ Risk of peritonitis (infection of the peritoneal cavity)

⛔ Protein loss in dialysate

⛔ Risk of hernias

⛔ Technique failure over time

⛔ Requires daily responsibility by the patient

⚠️ Common Complications:

1. Peritonitis – infection of the peritoneal cavity

Symptoms: Cloudy dialysate, abdominal pain, fever

Prevention: Strict aseptic technique

2. Exit-site or tunnel infections

Redness, discharge, pain around the catheter site

3. Catheter malfunction

Obstruction or migration

4. Hernias or leaks due to increased intra-abdominal pressure

5. Dialysate-related issues

Glucose absorption → weight gain or hyperglycemia

🧪 Monitoring in PD:

Weight and blood pressure daily
Monthly labs: Electrolytes, urea, creatinine, hemoglobin, albumin
Peritoneal Equilibration Test (PET): To assess membrane transport type

🆚 PD vs Hemodialysis:

Feature	PD	Hemodialysis
Location	Home	Dialysis center
Frequency	Daily	3x/week
Access	Abdominal catheter	AV fistula/graft
Equipment	Minimal (or cycler)	Dialysis machine
Independence	High	Moderate
Risks	Peritonitis	Vascular access infections, hypotension

🧑‍⚕️ Training & Support:

Patients and caregivers undergo training for 1–2 weeks
Nurses teach sterile technique, exchange process, and troubleshooting
Regular follow-up with nephrologist and dialysis nurse

🏠 Lifestyle:

Travel-friendly (portable supplies)
Compatible with work/school life
Diet more liberal than with hemodialysis (especially potassium and fluids)

Would you like a visual diagram of the process or a printable patient-friendly version (PDF)?

Or maybe info tailored for nurses, students, or patients?

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