Peritoneal dialysis

This is a method that is performed at home after a period of education in our dialysis centre. It differs fromhaemodialysis in that the blood is treated without passing through a circuit outside the body. It is your peritoneum (the membrane that surrounds the organs in the abdomen) that acts as a filter. It requires a surgeon to place a catheter in the abdominal cavity beforehand. The catheter exits the abdominal wall and is protected by a dressing. This method requires rigorous hygiene and a suitable home (hygiene and storage of equipment). With this method, exchanges are carried out several times a day, either by the patient himself or by a third party (nurse).

Continuous ambulatory peritoneal dialysis (CAPD)

In this treatment modality, 4 manual exchanges are carried out during the day, usually by the patient himself or by a nurse. Depending on the case, 1.5 litres to 3 litres are manually infused into the peritoneum at each exchange.

Automated peritoneal dialysis (APD)

This type of treatment is carried out while the patient is asleep, using a machine known as a cycler. It carries out the exchanges automatically. The treatment lasts from 8:00 to 10:00. DPA offers great flexibility of schedule for patients who still have a normal social or professional activity.

Peritoneal dialysis can present risks:

• Peritoneal infections or peritonitis,
• malnutrition (worsening of the condition)
• Insufficient purification (malfunction of the catheter and/or your peritoneum, disappearance of diuresis).

For these 2 treatment methods, medical monitoring is carried out at least once a month. An on-call team (nurse and nephrologist) is available 24 hours a day.

Peritoneal Dialysis: A home-based alternative

Peritoneal dialysis uses your own peritoneum (a natural membrane in your abdomen) to filter blood. Sterile dialysis fluid, called dialysate, is introduced into the abdomen via a peritoneal catheter, allowing waste products and excess fluid to be removed.

Peritoneal catheter
The catheter is inserted under local or general anesthesia. Flexible and discreet, it partially exits the abdomen and is securely fixed to prevent movement or dislodgement. It has a built-in one-way valve and an internal system to reduce infection risk. Between sessions, it should be protected with a sterile, waterproof dressing.

Stages of a peritoneal dialysis session

• Infusion: Dialysate is introduced into the abdomen
• Dwell time: The fluid remains in place to perform exchanges
• Drainage: Saturated dialysate is drained by gravity

Two modes of peritoneal dialysis

• Continuous Ambulatory Peritoneal Dialysis (CAPD): Manual exchanges about four times a day, six to seven days per week
• Automated Peritoneal Dialysis (APD): Performed at night using a machine called a cycler, offering more convenience for active lifestyles