Peritoneal dialysis

This is a short introduction. Further information, including videos and leaflets, is available from Renal Units. In Edinburgh, the Community Dialysis Team keeps this information. See also the further information at the foot of this page.

How does it work?

Waste products are removed across the natural membrane which lines the inside of the abdomen. This lining is called the peritoneum. The membrane is bathed in a special fluid passed into the abdomen through a small plastic tube. After a few hours this fluid is drained away and replaced by new fluid.

APD, or Automated Peritoneal Dialysis involves the use of a small simple machine. Most of your dialysis happens over approximately 8-9 hours at night. You are attached to the machine for the duration of your treatment, most people find it convenient and manage to sleep quite well once they are used to it. A small amount of involvement is required during the day but this is kept to the minimum and fits in with your plans. However, it may not offer the best treatment for everyone and it is something that will be discussed with your healthcare professionals.

CAPD, or Continuous Ambulatory Peritoneal Dialysis involves carrying out 4 fluid exchanges daily. They are usually 4-6 hours apart with a longer gap overnight. The time taken is usually 30-40 minutes and can be timed to fit in with your daily activities.
Basically all that is needed from you is a clean working surface and nearby handwashing facilities (not in the kitchen).

Click here to see an animation of how peritoneal dialysis works, from the Kidney Patient Guide (Wrexham Maelor Hospital, Wales). You need Flash Player on your PC (or Mac) to see it work (links to get this free are provided).
How is the tube put in?

This requires a small operation, usually under a general anesthetic. You are usually discharged home 1-2 days after your operation.

Generally after 2 or more weeks you will begin training in how to carry out the procedure. We find this usually takes around 6 days but this will depend on how you get on.

Does the tube remain in place?

Yes, the tube is securely fixed in place and remains there as long as it is required, months or even years, if necessary.

When dressed, it is virtually impossible to detect any visible sign the treatment is taking place although we find that some patients feel more comfortable wearing loose-fitting clothing.

What sort of problems can arise?

The main problem which can occur is peritonitis (inflammation of the peritoneum) and is easily recognised when the fluid draining out becomes cloudy. This is serious, but usually resolves with early treatment by antibiotics.

Other problems can occur, but they can usually be resolved. Remember, help is always at hand. The risk of developing an infection can be minimised by adhering to the simple procedures you will be shown while you are learning to do PD.

What about my diet on peritoneal dialysis?

Diet is important for dialysis patients. Go to our page about diet on PD.

Further information
ESRF (End stage renal failure) The EdRenINFO page on treatments for end stage renal failure, with links to other treatment types.
 NKF PD leaflet The NKF (UK) provides an excellent leaflet on peritoneal dialysis which is reproduced on their website. It is one that we give our patients in Edinburgh.
Kidney Patient Guide info The Kidney Patient Guide website has excellent explanations of dialysis techniques, and particularly good animations of how dialysis works. Your PC needs to have an up to date version of Netscape or Internet Explorer and Flash player to see these. But it’s worth it. There is also much other information about life on dialysis.

Acknowledgements:  The authors of this page were Richard Dingwall and his colleagues from the Community Dialysis Team. It was first published in January 2001. The date is was last modified is shown in the footer.