An exchange has 3 steps:
STEP 1: DrainA drain bag is connected to the PD catheter; the used and saturated solution inside the abdomen is drained. This solution contains waste and excess fluid.
STEP 2: FillAfter the abdomen is completely drained of the old solution, new dialysis solution is put in through the catheter to fill up the peritoneal cavity, which is located in the abdomen.
STEP 3: DwellWhen the new solution has been placed, the dialysis tubing and bags are removed. You wear only a short tubing set covered with a sterile cap and can continue your normal activities. During this dwell period of time, the dialysis solution stays in the peritoneal cavity. This is when the dialysis occurs and the solution collects the waste and excess fluid from your body.
There are two types of peritoneal dialysis:
CAPD stands for continuous ambulatory peritoneal dialysis and is a manual form of peritoneal dialysis.
CAPD means that you “exchange” old solution for new solution about four times every day. Dialysis happens continuously.
APD stands for automated peritoneal dialysis and is a form of peritoneal dialysis done by a machine.
The AMIA dialysis machine does the exchange. This is usually done at night, while you sleep, allowing you to carry on your daily activities during the day. AMIA will advise you if you need an extra exchange during the day.
The catheter is a small flexible tube that is placed through the wall of your abdomen, into the peritoneal cavity. It is a permanent access for peritoneal dialysis that is essential.
The peritoneal dialysis catheter lets the PD solution run into and out of your peritoneal cavity.
The catheter is usually placed slightly below and to the side of the navel. The exit site (the place where the tube comes out) can be located on your abdomen or chest. The catheter extends out of the body about 5–10 cm. It is your lifeline, so treat it with care.
Your renal care team will show you how to take care of your peritoneal dialysis catheter.
Key points to remember:
- Your nurse will walk you through the steps needed to do peritoneal dialysis at home
- Feel free to take notes and ask your dialysis nurse questions throughout your training
- It is important for you to be comfortable with this information
- Be actively involved in the learning process
- As you continue your training, you will gain confidence to perform your therapy at home
- Both CAPD and APD can be planned to fit into your family, work, and personal lifestyle
- Know that you are an important part of your renal team