An overview of Peritoneal Dialysis
Peritoneal dialysis is a treatment for kidney failure that involves using a cleansing fluid to filter waste products from the blood. There are two main types of peritoneal dialysis: Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cycling Peritoneal Dialysis (CCPD). The process of filling and draining the abdomen with the dialysis solution is called an exchange.
What is Peritoneal Dialysis used for?
Peritoneal dialysis is used as a treatment for kidney failure, a condition where the kidneys can't filter blood well enough any longer. The dialysis process involves using a cleansing fluid that flows through a tube into the peritoneum, the inner lining of the abdomen, which acts as a filter to remove waste products from the blood. Peritoneal dialysis can be done at home or while traveling, offering greater flexibility compared to hemodialysis, which filters blood outside the body in a machine. However, it requires the ability to self-care or the presence of a trusted caregiver. This treatment option is suitable for those who have kidney damage due to conditions such as diabetes mellitus, high blood pressure, glomerulonephritis, or polycystic kidney disease.
How to prepare for Peritoneal Dialysis?
Patients may need to prepare for peritoneal dialysis tests, including the peritoneal equilibration test (PET) and clearance test. Before these tests, it is important to follow your healthcare provider's instructions. In general, you may need to:
- Refrain from eating or drinking: Your healthcare provider may ask you to avoid eating or drinking for a period before the test. This ensures an empty stomach and accurate test results.
- Schedule the test: You should schedule the test at a time when you have a relatively stable health condition. If you're experiencing a flare-up of your kidney disease or other health issues, it's best to postpone the test until you're feeling better.
- Follow medication instructions: Continue taking your prescribed medications as directed by your healthcare provider.
- Prepare for the catheter placement: If you're undergoing a peritoneal equilibration test as part of evaluating your dialysis treatment, you may need to have a catheter placed in your abdomen. Your healthcare provider will give you specific instructions on how to prepare for the catheter placement procedure. Remember to follow your healthcare provider's recommendations to ensure the best possible test results and to optimize your dialysis treatment.
How is Peritoneal Dialysis conducted?
Peritoneal dialysis tests are conducted to evaluate the efficiency of the dialysis process in removing waste products and toxic substances from the blood. Two common tests used to assess the effectiveness of peritoneal dialysis are:
- Peritoneal Equilibration Test (PET): During a PET, blood samples and dialysis solution samples are taken and compared to determine the rate at which waste products and toxins move from the blood into the dialysis solution. This test helps determine the ideal dwell time for the dialysis solution in the abdomen, whether it should be shorter or longer.
- Clearance Test: A clearance test measures the levels of urea, a waste product, in blood and used dialysis fluid samples. This test helps determine the amount of urea being removed from the blood during dialysis. If the patient still produces urine, a urine sample may also be tested for urea levels. If the test results indicate that the dialysis routine is not removing enough waste products, the care team may adjust the treatment plan accordingly.
It is important to note that these tests are conducted under the guidance and supervision of a healthcare provider trained in peritoneal dialysis procedures.
How are Peritoneal Dialysis results reported?
Peritoneal dialysis results are reported through various tests that measure the efficiency of the treatment in removing waste products and extra fluids from the blood. These tests include the peritoneal equilibration test (PET) and clearance test. The test results help determine if the dialysis routine is effective and if any adjustments are needed, such as increasing the number of exchanges, using a dialysate with a higher concentration of sugar, or making changes to the dwell time. Additionally, the care team may monitor the patient's diet and medication adherence to optimize the peritoneal dialysis results.
Understanding the report
In interpreting the results of peritoneal dialysis, the following factors are considered:
- Your size: Your body size affects the amount of waste that needs to be filtered.
- How quickly the inner lining of your abdomen filters waste: This can vary from person to person.
- How much dialysis solution you use: The amount of dialysis solution determines the efficiency of the filtration process.
- The number of daily exchanges: The frequency of exchanges impacts the overall effectiveness of the treatment.
- Length of dwell times: The length of time the dialysis solution stays in the abdomen affects the removal of waste.
- The concentration of sugar in the dialysis solution: The sugar content can influence the dialysis process. To evaluate the effectiveness of peritoneal dialysis, tests such as the peritoneal equilibration test (PET) and clearance test are conducted. PET compares the rate of waste removal between blood and dialysis solution during an exchange, while the clearance test measures the levels of urea in blood and dialysis samples. If the test results show that dialysis is not removing enough waste, your care team may adjust your treatment by increasing exchanges, changing the dialysis solution, or modifying the dwell time.