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Home Dialysis

Peritoneal dialysis (PD) is typically done at home. To perform PD, the abdominal cavity is filled with dialysis fluid (called dialysate) through a catheter (a flexible tube). The catheter is surgically inserted into the abdomen near the umbilicus (belly button).

The fluid is held within the abdomen for a prescribed period of time (called a dwell). The lining of the abdominal cavity (the peritoneal lining) acts as a membrane to allow excess fluids and waste products to diffuse from the bloodstream into the dialysate. The used dialysate in the abdomen is then drained out and discarded. The peritoneal cavity is then filled again with fresh dialysate. This process is called an exchange.

The exchange may be done manually four to five times during the day. The exchange may also be done automatically using a machine (called a cycler) while you sleep.

Advantages

Advantages of peritoneal dialysis compared to hemodialysis include more uninterrupted time for work, family, and social activities. Most people who use PD are able to continue working, at least part-time, especially if exchanges are done during sleep.

Disadvantages

People who use PD must be able to understand how to set the equipment up and use their hands to connect and disconnect small tubes. If you cannot do this, a family or household member may be able to do it.

Disadvantages of peritoneal dialysis include an increased risk of hernia (weakening of the abdominal muscles) from the pressure of the fluid inside the abdominal cavity. In addition, you can gain weight and you have an increased risk of infection at the catheter site or inside the abdomen (peritonitis).