Risks Peritoneal dialysis

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Complications of peritoneal dialysis can include: Risks Peritoneal dialysis

  • Infections. An infection of the abdominal lining (peritonitis) is a common complication of peritoneal dialysis. An infection can also develop at the site where the catheter is inserted to carry the cleansing fluid (dialysate) into and out of your abdomen. The risk of infection is greater if the person doing the dialysis isn’t adequately trained.
  • Weight gain. The dialysate contains sugar (dextrose). Absorbing some of the dialysate might cause you to take in hundreds of extra calories daily, leading to weight gain. The extra calories can also cause high blood sugar, especially if you have diabetes.
  • Hernia. Holding fluid in your abdomen for long periods may strain your muscles.
  • Inadequate dialysis. Peritoneal dialysis can become ineffective after several years. You might need to switch to hemodialysis.

If you have peritoneal dialysis, you’ll need to avoid:

  • Certain prescription and over-the-counter medications that can damage your kidneys, including nonsteroidal anti-inflammatory drugs.
  • Soaking in a bath or hot tub, or swimming in a lake, pond, river or nonchlorinated pool — which increases the risk of infection. Showers and swimming in a chlorinated pool are generally acceptable.

How you prepare

You’ll need an operation to insert the catheter that carries the dialysate in and out of your abdomen. The insertion might be done under local or general anesthesia. The tube is usually inserted near your bellybutton.

After the tube is inserted, your doctor will probably recommend waiting up to a month before starting peritoneal dialysis treatments to give the catheter site time to heal.

You’ll also receive training on how to use the peritoneal dialysis equipment.

What you can expect

During peritoneal dialysis:

  • The dialysate flows into your abdomen and stays there for a prescribed period of time (dwell time) — usually four to six hours
  • Dextrose in the dialysate helps filter waste, chemicals and extra fluid in your blood from tiny blood vessels in the lining of your abdominal cavity
  • When the dwell time is over, the solution — along with waste products drawn from your blood — drains into a sterile collection bag

The process of filling and then draining your abdomen is called an exchange. Different methods of peritoneal dialysis have different schedules of exchange. The two main schedules are:

  • Continuous ambulatory peritoneal dialysis (CAPD)
  • Continuous cycling peritoneal dialysis (CCPD)

Continuous ambulatory peritoneal dialysis (CAPD)

You fill your abdomen with dialysate, let it remain there for a prescribed dwell time, then drain the fluid. Gravity moves the fluid through the catheter and into and out of your abdomen.

With CAPD:

  • You may need three to five exchanges during the day and one with a longer dwell time while you sleep
  • You can do the exchanges at home, work or any clean place
  • You’re free to go about your normal activities while the dialysate dwells in your abdomen

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