How Does Peritoneal Dialysis Treatment Work?

Peritoneal dialysis (PD) is one type of dialysis that uses the lining of the abdomen as a natural filter to clear waste from the body. A cleansing fluid called dialysate is introduced into the abdominal cavity through a catheter, where waste products and excess fluid pass into the fluid before being drained from the body.

Unlike haemodialysis, which filters blood through a dialysis machine in a clinic, PD is typically performed at home and may offer greater flexibility for patients.

There are two main types of peritoneal dialysis, both of which use the peritoneum as a natural filter to remove waste products and excess fluid from the body. The main difference lies in how the dialysis exchanges are performed, with different treatment schedules being offered according to the patient's medical needs and lifestyle.

CAPD is performed manually without the use of a machine. During treatment, dialysis solution is introduced into the abdomen through a catheter, where it remains for several hours to allow waste products and excess fluid to be filtered before being drained and replaced with fresh solution. These exchanges are typically performed three to five times throughout the day.

APD uses a machine known as a cycler to automatically perform fluid exchanges. Treatment is commonly carried out overnight while the patient sleeps, with the machine cycling dialysis solution in and out of the abdomen over approximately 8–10 hours according to a programmed schedule.

Starting peritoneal dialysis may initially feel intimidating, especially for patients adjusting to long-term kidney care. Understanding what the treatment process involves, from preparation and training to performing dialysis at home, can help patients feel more confident and better prepared for daily life with PD.

Before starting PD, patients will undergo medical assessments to evaluate their kidney function, overall health and suitability for treatment. A minor surgical procedure is then performed to place a catheter into the abdomen, which will be used to introduce and drain dialysis solution during treatment.

Patients and caregivers will receive training on how to safely perform PD at home, including hygiene practices, catheter care and how to carry out fluid exchanges. The home environment may also need to be prepared to ensure a clean and suitable space for treatment.

During PD, dialysis solution is introduced into the abdominal cavity through the catheter. The solution remains in the abdomen for a period of time, allowing waste products and excess fluid to pass through the peritoneal membrane into the fluid. Once filtration is complete, the used solution is drained and replaced with fresh dialysate. The treatment schedule and frequency of exchanges depend on whether CAPD or APD is being performed.

Patients undergoing PD will require regular follow-up appointments to monitor kidney function, review treatment effectiveness and check for potential complications such as infections. Adjustments to the dialysis plan may also be made over time according to the patient's condition and treatment needs.

Peritoneal dialysis offers greater flexibility and convenience for treatment, but also comes with certain risks and responsibilities that should be carefully considered with a kidney specialist.

For some patients, PD may provide a more manageable dialysis routine that can be integrated into daily life more independently.

Despite its convenience, PD still involves ongoing medical care and responsibilities that can affect daily life.

Adjusting to life with dialysis can take time, particularly for patients adapting to long-term treatment routines and lifestyle changes. Peritoneal dialysis may offer increased independence compared to other options, but it still requires significant adjustments to your daily routine, both physically and mentally. Patients will need time to adapt to performing regular exchanges, and during this period, having access to professional medical guidance and a clear understanding of the treatment can help make this transition feel more manageable over time.

At The Kidney Health Care Clinic, patients receive comprehensive kidney care led by Dr Alvin Ng Kok Heong, our senior consultant nephrologist. The clinic provides evaluation and management for a wide range of kidney conditions, including chronic kidney disease, kidney failure and dialysis-related care. Treatment plans are tailored according to each patient's medical condition, treatment goals and daily lifestyle considerations to support long-term kidney health management.

If you would like to learn more about peritoneal dialysis or discuss whether PD may be suitable for your condition, contact us today to arrange a consultation.

Dr Alvin Ng is a nephrologist in Singapore with more than 20 years of experience. He specialises in the diagnosis and management of a wide range of kidney conditions and is committed to providing comprehensive, personalised and evidence-based care for patients with kidney disease.

Prior to private practice, Dr Ng served as a consultant nephrologist at Changi General Hospital, where he was Director of the Peritoneal Dialysis Service and a member of the MOH Peritoneal Dialysis Workgroup. He has also held leadership roles within the Singapore Society of Nephrology and has been actively involved in the education of medical students, junior doctors and specialist trainees. His contributions to patient care, medical education and professional service have been recognised through multiple awards.