Dr Alvin Ng
Senior Consultant Nephrologist

Bachelor of Medicine and Surgery (Auckland, New Zealand)
Fellow of the Royal Australasian College of Physicians
Fellow of the Academy of Medicine, Singapore (Renal Medicine)

Healthy kidneys clean your blood and remove extra fluid in the form of urine. It’s other functions include balancing the salt and acid level in the body, produce hormones that stimulate red blood cell production, activates vitamin D and control blood pressure.

When a kidney no longer works, dialysis replaces some of these functions. There are two different types of dialysis – hemodialysis and peritoneal dialysis. The following is about peritoneal dialysis.

What is peritoneal dialysis?

Peritoneal dialysis is a medical treatment that uses the lining of the abdomen (peritoneum) to remove waste products and extra fluids from the blood when the kidneys are no longer able to function properly. During peritoneal dialysis, a special solution called dialysate is introduced into the patient’s abdomen through a catheter, which helps to draw waste products and excess fluids from the blood into the peritoneal cavity. The dialysate is then drained out of the abdomen, taking the waste products and extra fluids with it.

There are two main types of peritoneal dialysis: continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD). In CAPD, the patient manually introduces the dialysate into their abdomen several times a day and drains it out after several hours. In APD, a machine automatically cycles the dialysate through the abdomen at night while the patient sleeps.

Peritoneal dialysis is an alternative to hemodialysis for patients with end-stage kidney disease who cannot tolerate or do not wish to undergo hemodialysis. It can be done at home, which allows for greater flexibility and independence for patients. However, peritoneal dialysis may not be suitable for patients with certain medical conditions, such as patients with severe abdominal surgery or bowel disease. The choice between peritoneal dialysis and hemodialysis will depend on the individual patient’s medical condition and lifestyle factors.

Symptoms

What Does It Mean for a Patient to Undergo Peritoneal Dialysis?

For a patient to undergo peritoneal dialysis, it means that their kidneys are no longer functioning properly, and they require this medical treatment to remove excess waste products and fluids from their blood. Peritoneal dialysis uses the lining of the abdomen (peritoneum) to filter the blood, and it is a form of renal replacement therapy that can be done at home.

During peritoneal dialysis, a special solution called dialysate is introduced into the patient’s abdomen through a catheter. The dialysate helps to draw waste products and excess fluids from the blood into the peritoneal cavity. The dialysate is then drained out of the abdomen, taking the waste products and extra fluids with it.

Peritoneal dialysis is a continuous process that can be done several times a day or overnight using a machine. Unlike hemodialysis, which requires patients to travel to a dialysis center several times a week, peritoneal dialysis can be done at home, which provides greater flexibility and independence for patients.

Patients who undergo peritoneal dialysis will need to follow a strict schedule and take good care of their catheter site to prevent infections. They will also need to monitor their fluid intake and follow a special diet to manage their blood pressure and avoid complications. Peritoneal dialysis can significantly improve the quality of life for patients with end-stage kidney disease, allowing them to continue their daily activities and maintain a more normal lifestyle.

What Is the Difference Between Hemodialysis and Peritoneal Dialysis?

Peritoneal dialysis and hemodialysis are two forms of renal replacement therapy used to treat patients with end-stage kidney disease, but they differ in several ways:

Method of blood filtration
: Peritoneal dialysis filters blood inside the patient’s abdomen using the peritoneum as a natural membrane, while hemodialysis filters blood outside the body using a machine and artificial membrane.
Treatment setting
: Peritoneal dialysis can be performed at home or work by the patient or caregiver, whereas hemodialysis is typically done at a hospital or clinic by trained healthcare professionals.
Frequency and duration of treatment
: Peritoneal dialysis is usually done daily, with each treatment taking several hours, while hemodialysis is typically done three times a week for several hours per session.
Type of equipment needed
: Peritoneal dialysis requires a sterile bag of dialysate, a catheter, and a place to drain used dialysate. Hemodialysis requires a dialysis machine, needles, tubing, and a dialyzer.
Diet restrictions
: Peritoneal dialysis generally allows for a more liberal diet, while hemodialysis requires dietary restrictions on foods high in potassium, phosphorus, and sodium.
Risk of complications
: Peritoneal dialysis carries a risk of peritonitis, which is an infection of the peritoneum, while hemodialysis carries a risk of low blood pressure, muscle cramps, and access site infection.

The choice between peritoneal dialysis and hemodialysis depends on the patient’s lifestyle, medical condition, and personal preferences. Peritoneal dialysis may be preferred by patients who desire more independence, while hemodialysis may be preferred by patients who require more intensive medical monitoring and support.

Treatment Options

Monitoring and maintaining of optimum level of blood sugar along with treatment of other conditions, including high blood pressure and high cholesterol.

Do you have a question about your kidney or medical condition?

Reach out to us for a consultation with Dr Alvin Ng.

Our Peritoneal Dialysis Specialist

Dr Alvin Ng (黄国雄医生)

Bachelor of Medicine and Surgery (Auckland, New Zealand)
Fellow of the Royal Australasian College of Physicians
Fellow of the Academy of Medicine, Singapore (Renal Medicine)

Dr Alvin Ng is a senior consultant nephrologist with over two decades of experience in kidney care. Prior to setting up his own practice, Dr Ng was the Director of Peritoneal Dialysis at Changi General Hospital and an executive committee member of the Singapore Society of Nephrology. He has held teaching appointments for medical students and residents; and is also a recipient of various service awards – a testament to the quality of care he provides.