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 (capillaries) in the lining of your abdominal cavity (peritoneum)
- 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.
- 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
Continuous cycling peritoneal dialysis (CCPD)
Also known as automated peritoneal dialysis (APD), this method uses a machine (automated cycler) that performs multiple exchanges at night while you sleep. The cycler automatically fills your abdomen with dialysate, allows it to dwell there and then drains it to a sterile bag that you empty in the morning.
- You must remain attached to the machine for 10 to 12 hours at night.
- You aren't connected to the machine during the day. But in the morning you begin one exchange with a dwell time that lasts the entire day.
- You might have a lower risk of peritonitis because you connect and disconnect to the dialysis equipment less frequently than you do with CAPD.
To determine the method of exchange that's best for you, your doctor will consider your medical condition, lifestyle and personal preferences. Your doctor might suggest certain modifications to individualize your program.
Aug. 10, 2017
- AskMayoExpert. Peritoneal dialysis. Rochester, Minn.: Mayo Foundation for Medical Education and Research. 2015.
- Wein AJ, et al., eds. Etiology, pathogenesis, and management of renal failure. In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed Feb. 22, 2016.
- Johnson RJ, et al., eds. Peritoneal dialysis: Principles, techniques, and adequacy. In: Comprehensive Clinical Nephrology. 5th ed. Philadelphia, Pa.: Elsevier; 2015. http://www.clinicalkey.com. Accessed Feb. 22, 2016.
- Burkart JM. Pathophysiology and prevent of peritonitis in peritoneal dialysis. http://www.uptodate.com/home. Accessed Feb. 22, 2016.
- Treatment methods for kidney failure: Peritoneal dialysis. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/peritoneal/. Accessed Feb. 23, 2016.
- Rosenberg M. Overview of the management of chronic kidney disease in adults. http://www.uptodate.com/home. Accessed Feb. 22, 2016.
- Burkart JM. Choosing a modality for chronic peritoneal dialysis. http://www.uptodate.com/home. Accessed Feb. 22, 2016.
- Skorecki K, et al., eds. Peritoneal dialysis. In: Brenner and & Rector's The Kidney. 10th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed Feb. 22, 2016.
- Bieber SD, et al. Comparative outcomes between continuous ambulatory and automated peritoneal dialysis: A narrative review. American Journal of Kidney Diseases. 2014;63:1027.