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What is Peritoneal Dialysis?

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  • Written By: Malcolm Tatum
  • Edited By: Bronwyn Harris
  • Last Modified Date: 31 October 2016
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    Conjecture Corporation
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Peritoneal dialysis is a process that helps to remove impurities from the bloodstream. Along with hemodialysis, this form of blood cleansing is necessary when the liver is no longer capable of efficiently purifying the blood. While this form of dialysis is the most beneficial course of treatment for some patients, it is not the best option for everyone.

The process of peritoneal dialysis requires the surgical insertion of a catheter. The location for the catheter is some point along the abdominal cavity, usually toward either side, or just below the umbilicus. Because some types of this form of dialysis can be conducted outside a health care facility, the catheter is a permanent attachment that requires regular maintenance.

With the catheter in place, the actual treatment can begin. A bag of fluid, known as dialysate, is attached to the catheter and allowed to drain into the abdominal cavity. The contents of the dialysate include a mixture of plasma, glucose, sterile water, and electrolytes that is specified by the attending physician. Depending on the needs of the patient, the dialysate will remain in the abdomen for anywhere from sixty minutes to ten hours.

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During the time that the dialysate is in the abdominal cavity, the solution collects waste products from the body. When the liquid is expelled from the abdomen via the catheter, the waste is also expelled and captured in a catheter bag. As a result of the procedure, the blood is kept relatively free of impurities.

There are actually different types of peritoneal dialysis that are in common use today. Continuous ambulatory peritoneal dialysis makes use of gravity to allow the dialysate to drain into and out of the abdominal cavity over the course of anywhere from four to ten hours. This approach to dialysis is useful for people who prefer to conduct the procedure at home, or who wish to handle the process themselves while out of town.

A second option is known as automated peritoneal dialysis. This approach does require the use of what is known as a peritoneal cycling machine. Depending on the patient’s condition, this process can be employed mainly at night, with one longer session during the day. An alternate process, known as intermittent peritoneal dialysis, involves several long sessions each week, usually anywhere from ten to fourteen hours at a time. The intermittent method is rarely conducted in any setting other than a hospital.

One of the benefits of peritoneal dialysis is that it manages the blood purification process at a pace that is somewhat similar to normal liver function. This means there are no sudden drops in blood glucose or electrolytes that could lead to trauma to the body. Another advantage is that most forms of this treatment can be conducted in private at home, rather than having to go to a hospital or clinic.

However, there are some potential liabilities with peritoneal dialysis. The treatments do require more time than hemodialysis. The catheter could become obstructed, preventing the proper exchange of the dialysate. There is also the chance of infection at the site of the insertion, and some potential for bowel and bladder issues as a result of the catheter insertion.

The attending physician can assess the condition of the patient and explain why peritoneal dialysis may or may not be the best option. While there are some drawbacks, many people find this approach is less tiring than hemodialysis, and also allows them more time to engage in other activities. Many people respond well to this form of waste removal and experience few, if any, side effects.

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