In Peritoneal Dialysis, a membrane that is lining the person’s abdomen and covers the organs of the abdomen, called peritoneum, acts as a permeable filter.
The membrane consists of a rich blood vessel network and a large surface region. Blood substances may easily filter through the person’s peritoneum into the cavity of the abdomen, if condition is right. Fluids are infused through a catheter placed through the wall of the abdomen into peritoneal area within the patient’s abdomen. The fluid should be left in the abdomen for a sufficient period of time to let waste substances from the bloodstream to pass gradually into it.
After that, the fluids are drained out, discarded and substituted with fresh fluids. A porous polyurethane catheters or soft silicone rubbers are generally used because they allow the fluids to flow smoothly and are unlikely to result in injury. A catheter may be placed in place temporarily at the person’s bedside, or it can be placed permanently in the surgery room.
Different methods are performed for peritoneal dialysis.
1. In the Manual Intermittent Peritoneal Dialysis (the simplest technique), bag consisting of fluid is warmed to person’s body temperature; the fluids are infused in the cavity of the peritoneum for ten minutes, allowing to stay there for sixty to ninety minutes, and after that drained in approx. ten to twenty minutes. The full treatment may take twelve hours. This method is used mainly to treat acute failure of the kidney.
2. Automated Cycler Intermittent peritoneal dialysis may be done by patients in their home. A timed device is automatically pumps fluid into and draining it from the peritoneum’s cavity. Generally, patients set the cycler at bedtime, so the dialysis takes place while they are sleeping. Such treatment is required to be performed six or seven nights per week.
3. In Continuous Ambulatory Peritoneal Dialysis, the fluid must be kept in the patient’s abdomen for long intervals. Usually, the fluids are drained and replenished 4 or 5 times a day. The fluid is placed in collapsible polyvinyl chloride bag that may be folded when empty, tucket into a garments, and used for further draining without disconnecting a catheter. The patient usually does 3 of such fluid exchanges during a day, at intervals of four hours or longer. Each exchange takes thirty to fourty five minutes. Prolonged exchange (eight to twelve hours) is done at night during sleep.
4. In Continuous Cycler Assisted Peritoneal Dialysis, the person uses an an automated cycler to make short exchanges during sleep at night, while prolonged exchanges are done without the use of the cycler during a day. Such method minimizes exchanges number during the day, but preventing mobility at night time because of cumbersome equipments.
The complications may happen, in spite of many patients perform peritoneal dyalysis for years without any problems. Bleeding may appear at the site, where the catheter leaves the person’s body, or within abdomen’s internal organs can be perforated during inserting a catheter. Fluid can leak in the abdominal wall or around the catheter. The fluid flow can be obstructed by a clot or other debris. However, the major complication of peritoneal dialysis is an infection. The infection may involve the catheter’s skin site (peritoneum), resulting in abscess. Infection usually treated with antibiotics. Other complications may include: peritoneal sclerosis, hypothyroidism, seizures, hyperglycemia, and constipation.