The Kidney Clinic

A general insight on Peritoneal Dialysis

A general insight on Peritoneal Dialysis

What You Need to Know About Peritoneal Dialysis

Peritoneal dialysis is viable for patients whose kidneys cannot filter wastes and excess bodily fluids. This article will explore the fundamentals of peritoneal dialysis: its purpose, who can benefit from it, its pros and cons when compared to hemodialysis, and what to expect while undergoing treatment with a kidney specialist.

How It Works

Peritoneal dialysis relies on a membrane within the abdominal region, known as the peritoneal membrane, for its efficacy. It works by allowing a unique solution, known as dialysate, to pass into this via a catheter. This fluid draws toxins and excess fluid from the bloodstream, which is expelled along with the solution. The frequency of this process in a day can vary according to an individual’s specific needs.

When Will I Need Dialysis?

Patients suffering from End-Stage Renal Disease (ESRD) may be suitable candidates for peritoneal dialysis, especially when they have the physical ability and mental capacity to undergo the procedure independently. This form of dialysis can also provide an alternative to hemodialysis, which requires utilizing a machine to filter blood.
It is not advisable for patients with pre-existing medical problems to undergo peritoneal dialysis. Such conditions include severe abdominal adhesions, inflammatory bowel disease, and multiple previous abdominal surgeries

What Are the Pros and Cons of Peritoneal Dialysis (PD) vs Hemodialysis

Pros: Peritoneal dialysis offers patients more control over their treatment and gives them greater independence and flexibility. This is because it can be performed in the comfort of their own homes. The absence of the need for a machine is another benefit, which can make it more suitable for specific individuals.
Compared to hemodialysis, peritoneal dialysis is often easier on the body as it minimizes any fluctuations in blood pressure and other potential risks.

Cons: As peritoneal dialysis may be performed independently at home, it demands an added degree of patient accountability and dedication. To successfully perform the procedure, patients must be able to do it themselves or get a caregiver’s help several times daily.
Additionally, compared to hemodialysis, peritoneal dialysis poses a greater risk of infection due to its use of a catheter. Such conditions can lead to the severe complication of peritonitis, which can potentially be life-threatening.

What to Expect During Peritoneal Dialysis Treatment

Before starting peritoneal dialysis, a catheter must be placed into the patient’s abdomen, which is usually done under local anaesthesia. After the catheter is inserted, patients need to learn how to do the procedure themselves or have a caregiver available to help them.
Peritoneal dialysis requires patients to insert the solution into their abdomen daily and allow it to sit for an allotted time before draining it out. This process needs to be carried out multiple times a day, as instructed by the patient’s doctor.
During the process, a patient may experience slight discomfort, which can generally be managed with medications. It is also essential to follow specific dietary guidelines while taking prescribed drugs to keep their blood pressure and other medical issues in check.

Catheter Site Care

Keeping your catheter site clean and free from infection is critical in preventing a serious medical condition such as peritonitis, which may require medication or hospitalization in severe cases. Therefore, taking proper care of your catheter entry point is essential to ensure successful dialysis treatment.

Patients should follow these steps:

► Wash your hands with soap before touching the catheter site.
► Clean the skin around the catheter site with an antiseptic solution, such as chlorhexidine. Use a clean cloth or a sterile gauze to apply the solution and let it dry completely.
► Use sterile gloves to handle the catheter and connections.
► Inspect the catheter site for signs of infection, such as redness, swelling, or discharge. Notify your specialist if you notice any signs of infection.
► After each dialysis session, flush the catheter with heparin solution to prevent blood clots from forming.
► Secure the catheter to prevent accidental dislodgement.

Patients on peritoneal dialysis should also take the following precautions:

► Avoid swimming or soaking in a bathtub or hot tub, as these activities can increase the risk of infection.
► Avoid tight clothing or anything that puts pressure on the catheter site.
► Avoid lifting heavy items or strenuous physical activity that may strain the catheter site.

Peritoneal dialysis, although beneficial, may not be suitable for everyone. It is essential to consult with your kidney specialist and available kidney treatments, to determine if it is the right option for you.

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