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When a person has lost kidney function and requires dialysis, they must choose either hemodialysis or peritone al dialysis. Like hemodialysis, peritoneal dialysis is a procedure that replaces the work of your kidneys, removing extra water, wastes, and chemicals from your body. This type of dialysis uses the lining of your abdomen to filter your blood. This lining is called the peritoneal membrane.

A cleansing solution, called dialysate, travels through a special tube into your abdomen. Fluid, wastes, and chemicals pass from tiny blood vessels in the peritoneal membrane into the dialysate. After several hours, the dialysate gets drained from your abdomen, taking the wastes from your blood with it. Then you fill your abdomen with fresh dialysate and the cleaning process begins again.

Before your first treatment, a surgeon places a small, soft tube called a catheter into your abdomen. This catheter always stays there. It helps transport the dialysate to and from your peritoneal membrane.

There are three types of peritoneal dialysis: Continuous Ambulatory Peritoneal Dialysis (CAPD) is the most common type of peritoneal dialysis. It needs no machine. It can be done in any clean, well-lit place. With CAPD, your blood is always being cleaned. The dialysate passes from a plastic bag through the catheter and into your abdomen. The dialysate stays in your abdomen with the catheter sealed. After several hours, you drain the solution back into the bag. Then you refill your abdomen with fresh solution through the same catheter and the cleaning process begins again.

Continuous Cyclic Peritoneal Dialysis (CCPD) is like CAPD except that a machine, which connects to your catheter, automatically fills and drains the dialysate from your abdomen. The machine does this at night while you sleep.

Intermittent Peritoneal Dialysis (IPD) uses the same type of machine as CCPD to add and drain the dialysate. IPD can be done at home, but it's usually done in the hospital. IPD treatments take longer than CCPD.

CAPD is a form of self-treatment. It needs no machine and no partner. However, with IPD and CCPD, you need a machine and the help of a partner (family member, friend, or health professional).

With CAPD, the dialysate stays in your abdomen for about 4 to 6 hours. The process of draining the dialysate and replacing fresh solution takes 30 to 40 minutes. Most people change the solution four times a day. With CCPD, treatments last from 10 to 12 hours every night. With IPD, treatments are done several times a week, for a total of 36 to 42 hours per week. Sessions may last up to 24 hours.

Warning:  Changes should never be made in a patient's treatment or care based solely on the information found here.  Every patient has unique healthcare concerns and considerations and all these factors must all be taken into account before any changes can be safely made.  All medical and therapeutic decisions must come from a qualified health care provider.  Read RenalWEB's Legal Disclaimer before proceeding.


  NEWS AND LATEST ARTICLES
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Is There Such a Thing As Biocompatible Peritoneal Dialysis Fluid? - Free, Full-Text Article from Pediatric Nephrology. - October 2017

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No Increase in Small Solute Transport in Peritoneal Dialysis Patients Treated without Hypertonic Glucose for 54 Months - Free, Open Access article from BMC Nephrology. - August 31, 2017

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Peritoneal Dialysis: The Unseen Burden Placed on Patients - Posting from Nephrology Journal Club. - August 13, 2017

"In the end, the system needs to be dynamic, flexible, and aware. Enough to be proactive, not reactive, about keeping people healthy and happy. Granted, things are light years ahead of what they were thirty years ago. The almost constant medical and technological innovation I have seen in my lifetime with regards to dialysis and patient care is incredible. And yet, in areas such as patient education, preparation, day-to-day assistance, and communication with healthcare teams can still be quite lacking."

Editor's note: If there had been a significant financial incentive for dialysis providers to keep working-age patients employed, providers would have focused on reducing the burdens for dialysis patients long ago.

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  WEB RESOURCES
blue ball Latest Scientific Journal Articles on Peritoneal Dialysis Adequacy
Full text articles! Latest issue of the Advances in Peritoneal Dialysis
Latest issue of Peritoneal Dialysis International
Development of a Peritoneal Dialysis Program - full-text paper from Blood Purification. - January 2011
Handbook of Peritoneal Dialysis - 2011 paperback by Steven Guest, MD now available on Amazon.com
Hernias and peritoneal dialysis: What you need to know - from the Home Dialysis Central web site
How You Look on PD: Coping with Body Image Changes - Article from Home Dialysis Central. - September 2010
blue ball Peritoneal Dialysis - this is a growing library of key high-impact articles in nephrology, chosen by UKidney's contributors as suggested reading for nephrology trainees and practitioners.
PD Advanced Renal Educational Program - from Fresenius Medical Care (FMC)
Peritoneal Dialysis: A Treatment for Kidney Disease - transcript from the Kidney & Urology Foundation of America (KUFA) web site
PD and Home Hemo Coverage Maps from Home Dialysis Central web site
PD in a pinch: Low-volume, recumbent-only (LVRO) - from the Home Dialysis Central web site
Peritoneal Dialysis Q&A from Home Dialysis Central web site
Peritoneal Dialysis (PD) Catheter Placement: What to Expect - from Home Dialysis Central web site
Tailoring automated PD (APD) to your life - from Home Dialysis Central web site
Teaching Nurses to Teach Peritoneal Dialysis Training from the International Society for Peritoneal Dialysis (ISPD) web site
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  ESSENTIALS AND CLASSICS
Peritoneal Dialysis Nurse Resource Guide (pdf format requires Adobe Acrobat reader) from the ANNA web site
European Best Practice Guidelines for Peritoneal Dialysis - guidelines endorsed by the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA)
blue ball Handbook of Peritoneal Second Edition by Steven Guest MD
Basics of PD Prescription Writing - Blog entry from Renal Fellow Network
Peritoneal Dialysis Fact Sheet (pdf format requires Adobe Acrobat reader) from the ANNA web site
Pediatric Peritoneal Dialysis Fact Sheet (pdf format requires Adobe Acrobat reader) from the ANNA web site
Peritoneal Dialysis Adequacy quality improvement from The Renal Network (ESRD Network 9/10) web page
International Society for Peritoneal Dialysis ISPD
Peritoneal Dialysis Dose and Adequacy from the NKUDIC web site
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  PUBMED SEARCHES (National Library of Medicine's MEDLINE Database)
adequacy and peritoneal dialysis Continually Updated!
CANUSA and peritoneal Continually Updated!
MEDLINE / Pubmed Information from the National Library of Medicine
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  K/DOQI™ -  Kidney Disease Outcomes Quality Initiative
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Clinical Practice Guidelines for Peritoneal Dialysis Adequacy 2016 Updates

Clinical Practice Guidelines for Peritoneal Dialysis Adequacy 2006 Updates

I: Clinical Practice Guidelines for Peritoneal Dialysis Adequacy

Guideline 1. Initiation of Dialysis
Guideline 2. Peritoneal Dialysis Solute Clearance Targets and Measurements
Guideline 3. Preservation of Residual Kidney Function
Guideline 4. Maintenance of Euvolemia
Guideline 5. Quality Improvement Programs
Guideline 6. Pediatric Peritoneal Dialysis

II. Clinical Practice Recommendations for Peritoneal Dialysis Adequacy

Clinical Practice Recommendation for Guideline 1: Initiation of Dialysis
Clinical Practice Recommendations for Guideline 2: Peritoneal Dialysis Prescription Targets and Measurements
Clinical Practice Recommendations 3: Recommended Laboratory Measurements for Peritoneal Membrane Function and Ultrafiltration Volume
Clinical Practice Recommendations 4: Writing the Peritoneal Dialysis Prescription
Clinical Practice Recommendations for Guideline 6: Pediatric Peritoneal Dialysis

K/DOQI Home Page from the National Kidney Foundation web site
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  DISCUSSION FORUM
Peritoneal Dialysis Discussion Forum - RenalWEB Discussion Forum
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  PRODUCTS
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  UPCOMING EVENTS
Listing of local ESRD Network Annual Meetings
Listing of International Society for Peritoneal Dialysis (ISPD) Events
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  INPUT / SUGGESTIONS
E-mail to RenalWEB on the Peritoneal Dialysis Adequacy Topic
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