Many factors affect how well peritoneal dialysis works in removing wastes and extra fluid from your blood. These factors include:
- Your size
- How quickly your peritoneum filters waste
- How much dialysis solution you use
- The number of daily exchanges
- Length of dwell times
- The concentration of sugar in the dialysis solution
To check if your dialysis is removing enough waste products, your doctor is likely to recommend:
- Peritoneal equilibration test (PET). This test compares samples of your blood and your dialysis solution during an exchange. The results indicate whether waste toxins pass quickly or slowly from your blood into the dialysate. That information helps determine whether your dialysis would be improved if the solution stayed in your abdomen for a shorter or longer time.
- Clearance test. A blood sample and a sample of used dialysis solution are analyzed to determine how much of a certain waste product (urea) is being removed from your blood during dialysis. If you still produce urine, your doctor may also take a urine sample to measure its urea concentration.
If the test results show that your dialysis schedule is not removing enough wastes, your doctor might change your dialysis routine to:
- Increase the number of exchanges
- Increase the amount of dialysate you use for each exchange
- Use a dialysate with a higher concentration of dextrose
You can improve your dialysis results and your overall health by eating the right foods, including foods low in sodium and phosphorus. A dietitian can help you develop an individualized meal plan based on your weight; your personal preferences; and your remaining kidney function and other medical conditions, such as diabetes or high blood pressure.
Taking your medications as prescribed also is important for getting the best possible results. While you're receiving peritoneal dialysis, you'll likely need various medications to control your blood pressure, stimulate production of red blood cells, control the levels of certain nutrients in your blood and prevent the buildup of phosphorus in your blood.
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.