Peritoneal Dialysis

Peritoneal dialysis (PD) is a form of dialysis done at home either by the patient or, in some cases, with the assistance of a care giver. 

What are the benefits of peritoneal dialysis?

With peritoneal dialysis you can:

• dialyze at home
• set your dialysis schedule    
• manage your own care
• work  
• enjoy less potassium restrictions in your diet
• travel
• lower your risk of infections
• avoid needles
• help your kidneys last longer

How does peritoneal dialysis work? 

With peritoneal dialysis, the blood is cleaned inside the body, using it as a natural filter. It is a gentler form of dialysis that lets your kidneys hold onto their remaining function longer.

A peritoneal catheter (soft tube) is placed into the peritoneal cavity in your belly. The peritoneal cavity membrane surrounds internal organs and is the filter that will be used to clean the blood.

Using the catheter, the peritoneal cavity is filled with clear fluid (called dialysate). Over time, the fluid put into your body collects waste. This waste fluid is then drained through the catheter before fresh fluid is put in again. This is called a peritoneal dialysis exchange.

How often do I need peritoneal dialysis? 

If you choose peritoneal dialysis, you will need to dialyze every day, often overnight while you sleep. 

You will also need to visit the Provincial Renal Clinic at the Queen Elizabeth Hospital in Charlottetown every two to four months for assessment by health care team members. 

What are the types of peritoneal dialysis?

Manual or Twin Bag Method: a.k.a. CAPD (continuous ambulatory peritoneal dialysis)

With this method, no machine is used, only gravity. Dialysate fluid stays in the peritoneal cavity (belly area) at all times Exchanges are done by the person four to five times every day. Each exchange takes about 30 minutes to complete.

Automatic/Cycler Method: a.k.a. CCPD (continuous cycling peritoneal dialysis) or APD (automated peritoneal dialysis) 

This method is done by a compact, portable machine overnight for about nine hours while asleep. 

Dialysate fluid stays in the belly cavity for short periods of time before the machine drains it out and fills with fresh dialysate (this is called cycling) 

In the morning, one last fill will occur before disconnecting. This fluid may stay in the belly cavity the entire day. In some cases, people using the automatic method may have to do a manual exchange during the day

What supplies and equipment do I need for peritoneal dialysis?

Peritoneal dialysis equipment and supplies include:

• boxes of dialysis solutions and a warmer
• small supplies for cleaning the peritoneal dialysis catheter exit site
• a digital scale and blood pressure machine (provided by the Provincial Renal Program)
• if using the CCPD method, a night cycler that is about 7” x 19.5” x 15.7” and weighs about 27 lbs. 

Supplies can be stored in any warm, dry space away from pets. 

The Provincial Renal Program covers the cost of all supplies required for peritoneal dialysis and their delivery. Patients are responsible for ordering and maintaining enough supplies.

What do I need in my home for peritoneal dialysis?

One month of peritoneal dialysis supplies may require the floor space of a twin-size bed or a double closet. If you do not have enough space, speak with a clinic registered nurse to explore options. 
To ensure the best possible environment for peritoneal dialysis, your home should also have:

• a telephone in case you need to call for support
• a clean work area                
• suitable water, plumbing and electricity

Can I do peritoneal dialysis if I live in an apartment?

Yes, peritoneal dialysis can be done in apartments.

Can I do peritoneal dialysis if I have pets?

Yes, but pets must be kept away from your peritoneal dialysis supplies and the treatment area.

What can I eat and drink if I do peritoneal dialysis? 

Your renal dietitian will help you determine the best diet for your needs.

Can I travel on peritoneal dialysis?

Yes, with some planning. For more information, see Travel and Vacation Planning for Dialysis Patients and the Kidney Campus Travel Club. 

Do I need a referral for peritoneal dialysis?

Yes. You need to be referred to the Provincial Renal Clinic by a physician or nurse practitioner.

How do I get started with peritoneal dialysis? 

Reach out to the Provincial Renal Clinic. 

Call 902-894-0019 to speak with a Renal Clinic registered nurse about your options and/or set up an assessment appointment.

Attend an assessment appointment.

During your assessment, health care team members will:  

• review the peritoneal dialysis process with you
• show you peritoneal dialysis equipment and supplies
• answer questions and address any concerns you may have
• ask you to perform some simple tasks to determine if you would need assistance with peritoneal dialysis

Bring a partner or support person to the assessment meeting if possible. 

After the peritoneal dialysis assessment, if the patient and health-care team agree peritoneal dialysis is a good option for you, they will work with you to plan the steps towards education and training.

Receive your catheter.

If you move forward with peritoneal dialysis, you will receive a catheter in your belly area. Catheter surgery takes about an hour and requires a few hours stay in hospital (not overnight).

The catheter needs a few weeks to heal before you can be trained to do your own peritoneal dialysis treatments.

You’ll be taught how to keep your catheter site clean and monitor it for any sign of infection. Keeping the site clean is important and reduces the chance of infection.

If you have concerns or questions about your catheter site, ask your health-care team.

Attend training and visit the clinic.

Peritoneal dialysis nurses at the Provincial Renal Clinic (located at the Queen Elizabeth Hospital in Charlottetown) will train you to do your own peritoneal dialysis treatments. 

Training takes three to five days and is available from Monday to Friday. Talk with your health care team if you need help arranging transportation.

Once trained, you will have access to 24-hour support by telephone. You will need to visit the Provincial Renal Clinic at the Queen Elizabeth Hospital in Charlottetown every three months for assessment by health care team members.

 

What happens if I decide to stop peritoneal dialysis?

If you decide to discontinue peritoneal dialysis, you have the option of in-centre hemodialysis or conservative care. 

The dialysis machine and warmer will be removed from the home. You will be responsible for arranging for removal or disposal of other dialysis supplies.

About the Provincial Renal Program

Health PEI provides a range of kidney care and related services through the Provincial Renal Program to prevent, diagnose, and treat kidney disease including:  

• dialysis (in-centre hemodialysis and peritoneal dialysis),
• pre and post kidney transplant care,
• conservative kidney management care,
• early kidney disease prevention, education, and treatment
• support to patients and families 

Contact the PEI Provincial Renal Clinic

QEH Ambulatory Care Centre
60 Riverside Drive
Charlottetown, PE C1A 8T5

Telephone: 902-894-0019
Fax: 902-620-0497