Treating Kidney Failure With Peritoneal Dialysis
APPENDIX B. Words You Need to Know
To learn more about chronic kidney disease and its treatments, you’ll need to learn the special words associated with these subjects. Here are some definitions of terms that may be new to you.
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z
A
ABDOMEN: The part of the body that contains the digestive organs. It is also called the abdominal cavity or peritoneal cavity.
ACCESS: In peritoneal dialysis, a soft plastic tube is surgically placed, just below your belly button to provide a way to move the dialysate in and out of your abdominal cavity. (See also catheter.)
ALBUMIN: Albumin is a type of body protein made from the protein you eat each day. A low level of albumin in your blood may be caused by not getting enough protein or calories from your diet. A low level of albumin may lead to health problems such as difficulty fighting off infections.
ANEMIA: A condition caused by a decrease in the number of red blood cells in your body. Symptoms include paleness, weakness, fatigue and shortness of breath.
ANESTHETIC: A substance that produces a temporary loss of feeling, especially a loss of the sensation of pain.
ANTIBIOTICS: Medications that kill or stop growth of germs that cause infection.
ARTIFICIAL KIDNEY: In hemodialysis, a filtering device that removes excess fluid and waste products from the bloodstream. It is also referred to as a dialyzer.
B
BACTERIA: A type of germ that can enter your body and cause infections. This is why access sites must be cleaned before dialysis begins. Transplant patients may have increased susceptibility to infections because the anti-rejection medications lower the body’s defenses.
BATH: In dialysis, a mixture of purified water and chemicals that is similar to body fluids without the waste products. It is also called dialysate.
BLOOD PRESSURE: The pressure of your blood against the walls of your arteries. In a blood pressure reading, the top number, or systolic pressure, is the pressure when the heart pushes blood out, and the bottom number or diastolic reading is the pressure between beats, when the heart fills up with blood. High blood pressure (hypertension) is a leading cause of kidney failure, heart attacks and strokes.
BLOOD CHEMISTRIES: A variety of lab tests that provide a measure of your health and kidney function. Some tests like BUN, creatinine and potassium are related to your chronic kidney disease and treatment.
BLOOD VESSEL: Either an artery or a vein that carries blood through the body.
C
CALCIUM: A mineral in the blood that contributes to bone formation and body function.
CAPD (Continuous Ambulatory Peritoneal Dialysis): A form of dialysis in which a catheter is surgically placed in the lower abdomen so dialysate can be drained in and out of the peritoneal cavity. Dialysate exchanges are done every 4 to 6 hours. CAPD can be done at work, at home, or anywhere a clean, private place is available.
CARE PARTNER: In peritoneal dialysis, a specific person (spouse, family member, friend or paid-helper), who is trained to assist you with home-based peritoneal dialysis treatments.
CATHETER: A small plastic tube placed into the body through the skin or a body opening to add or withdraw fluids. In peritoneal dialysis patients, a catheter is surgically implanted in the lower abdomen. In some hemodialysis patients, a catheter-type access is placed into a vein in the neck or upper chest.
CCPD (Continuous Cycling Peritoneal Dialysis): A type of peritoneal dialysis that uses a machine called a cycler to make the bag exchanges, instead of the patient doing this by hand as in CAPD.
CHLORIDE: A salt present in normal, whole blood as sodium chloride. In peritoneal dialysis, it is part of the bath or dialysate solution.
CHRONIC KIDNEY DISEASE: Progressive loss of kidney function caused by diseases like diabetes, high blood pressure, glomerulonephritis, polycystic kidney disease, etc. It may eventually lead to complete, irreversible loss of kidney function, requiring treatments like dialysis or a kidney transplant to maintain life. (See kidney failure.)
CREATININE: A byproduct of muscle metabolism that is normally removed from the blood by the kidneys. Tests that measure creatinine levels are used to calculate kidney function in working kidneys. For people on dialysis, these tests are used to measure the effectiveness of dialysis treatments.
CREATININE CLEARANCE: A 24-hour urine test that is done to measure your remaining kidney function.
CYCLER: A cycler is a machine used to fill and drain dialysate fluid from the abdomen in peritoneal dialysis.
D
DEHYDRATION: A condition resulting from excessive loss of body water.
DELIVERED DOSE: A measure of the amount of dialysis you receive in a treatment. It tells how effectively your treatments are removing wastes from your blood. (See also Kt/V.)
DEXTROSE: A sugar present in dialysate fluid, some of which is absorbed into your blood during PD.
DIABETES: A disease that occurs when the amount of sugar in your blood is too high. This can happen when the body no longer makes enough insulin or is unable to use insulin properly. Diabetes is the leading cause of kidney failure, and is associated with other health problems such as heart disease, eye problems and nerve damage.
DIALYSATE: The cleansing solution used in dialysis to remove excess fluids and waste products from the blood when the kidneys have failed. This is also known as dialysis solution or bath.
DIALYSATE BAG: The exchange bag that holds the cleansing solution used in dialysis to remove excess fluids and waste products from the blood when the kidneys have failed.
DIALYSIS: The process of maintaining the chemical and fluid balance of the blood when the kidneys have failed.
DIALYSIS PRESCRIPTION: The prescription that tells your dialysis care team how to give you the right amount of dialysis. In peritoneal dialysis, the prescription includes: the amount of fluid and dextrose (sugar) concentration in each dialysate bag, the number of exchanges to be done each day and the dwell time between exchanges.
DIALYZER: The vessel that contains the membrane for blood and dialysate flow during hemodialysis. It is also called the artificial kidney. (In peritoneal dialysis, a dialyzer isn’t used. Rather, the membrane of the patient’s own abdominal cavity is used as a filter, instead.)
DIFFUSION: When particles from a highly concentrated solution move into a solution with a lower concentration. This process helps to cleanse and balance the blood during dialysis.
DRAIN STAGE ("OUTFLOW" STAGE): The first stage in the PD cycle, in which used dialysate is drained out of the abdominal cavity.
DWELL STAGE: The third stage in the PD cycle, in which dialysate is left to "dwell" inside the abdominal cavity for several hours.
E
EDEMA: Swelling in a specific part of the body (usually the ankles, face, eyelids or abdomen due to buildup of fluid in the body.
EXCHANGE: In peritoneal dialysis, the process of draining used dialysate from the peritoneal cavity, and replacing it with fresh solution.
EXIT SITE: In peritoneal dialysis, the place where the catheter comes out of the skin.
F
FIBRIN: A protein that is essential to the clotting of blood.
FILL STAGE ("INFLOW" STAGE): The second stage in the PD cycle, in which the abdominal cavity is filled with fresh dialysate fluid.
FILTER: In dialysis, a membrane that allows some things to pass through and holds back others. In peritoneal dialysis, the patient’s own peritoneal membrane acts as a natural filter, which allows waste particles and fluid to pass through, but does not allow blood cells to pass through (since they are too large).
FLUID INTAKE: The amount of fluid taken into the body.
H
HEMODIALYSIS: A type of dialysis that involves the use of an artificial kidney , or dialyzer, to filter waste products and excess fluid from the blood. Treatments typically last for three or four hours, three times a week, and take place at home or in a dialysis center.
HEMATOCRIT: A measure of your red blood cell level. A low hematocrit is associated with anemia, causing fatigue and a low energy level. (See also anemia, hemoglobin, red blood cells.)
HEMOGLOBIN: The part of red blood cells that carries oxygen to your cells. A low level of hemoglobin may indicate that you need treatment for anemia. (See also hematocrit.)
HEPARIN: A medication that helps to keep the blood from clotting.
HEPATITIS: A virus infection that affects the liver. It is spread by contact with infected blood.
HERNIA: An abnormality that happens when an organ or other body tissue protrudes through either a natural opening or a defect in the surrounding membrane.
HIV (Human Immunodeficiency Virus): The virus that is responsible for AIDS, or Acquired Immunodeficiency Syndrome. This disease weakens the body’s immune system, making you more susceptible to infections and other diseases.
HORMONE: A chemical substance produced in the body, which controls the activity of certain cells.
I
INFECTION: An illness that results when germs attack part of the body.
INSULIN: A hormone made in the pancreas, which regulates the amount of sugar in the blood. An insufficient amount of insulin results in diabetes. Insulin is also used as a medication to treat diabetes.
IRON: A mineral that is needed for the production of red blood cells in your body. Hemodialysis patients often develop anemia–a low red blood cell count. Anemia causes you to feel tired and have little energy for daily tasks. Your dialysis care team will check your iron levels to make sure they are in the right range. If your iron level is too low, you may need to take iron supplements to help your body build red blood cells. (See anemia)
K
KIDNEY FAILURE: The stage in chronic kidney disease where 85 to 90 percent or more of kidney function has been lost, and dialysis or a kidney transplant is required to maintain life. It is also called end stage renal disease, or ESRD.
KIDNEYS: The two vital organs, located behind the abdominal cavity, which maintain the balance of fluids and chemicals in the blood, remove waste products from the blood, release important hormones and help to regulate blood pressure.
KT/V: A measure of your delivered dose, or the amount of dialysis you receive in a treatment. This measurement tells your dialysis care team how effectively your treatments are removing wastes from your blood. (See also delivered dose.)
L
LIPID: Refers to any of a group of natural fat substances in your blood.
M
MAGNESIUM: A mineral that is important to good nutrition.
MEDICAID: A state-run program, partly funded by the federal government, which helps to pay for the health care of low-income (or no-income) patients.
MEDICARE: A type of federal medical insurance provided by the Social Security Administration, which pays for many of the medical costs associated with dialysis and transplantation as well as other medical expenses.
MEMBRANE FUNCTION: Refers to how well your peritoneal membrane works. Tests to assess membrane function after PD has started can play an important role in the way your dialysis prescription is adjusted.
METABOLISM: The process by which foods are broken down and used for energy and other body functions.
N
NIPD (Nighttime Intermittent Peritoneal Dialysis): A type of peritoneal dialysis that is basically the same as CCPD, except that the dialysate fluid is drained out in the morning and no exchanges are done during the day. In other words, the patient’s abdomen remains dry during the day.
O
OSMOSIS: The passage of fluid through a membrane--from a solution of lesser particle concentration to one of higher particle concentration--until the particles are distributed evenly.
OSTOMY: A surgical opening into an organ. An example is a colostomy, which is an opening into the large intestine. (PD would not be a good treatment option for a person with an ostomy.)
ORAL: Taken by mouth, such as a medication taken in liquid or pill form.
P
PARATHYROID GLANDS: Four glands in your neck, which release a hormone that regulates calcium and phosphorus levels in your blood. This is important to maintaining healthy bones.
PARATHYROID HORMONE (PTH): A hormone released by the parathyroid glands to help regulate calcium and phosphorus levels in your blood. High levels of PTH may cause bone disease. (See also parathyroid gland.)
PERITONEAL DIALYSIS (PD): A type of dialysis that uses the lining of your peritoneal cavity, called the peritoneum, as a natural filter to remove waste products and excess fluid from your blood.
PERITONEAL EQUILIBRATION TEST (PET): A test that evaluates the status of your peritoneal membrane. If your membrane is not functioning as well as it should, you may not be getting enough dialysis. If this occurs, your dialysis care team may recommend that you do extra exchanges each day, use a cycler occasionally, or switch to hemodialysis.
PERITONEAL DIALYSIS CYCLE: The three stages it takes to do peritoneal dialysis are the "drain" stage (emptying out used dialysate) the "fill" stage (adding fresh dialysate) and the "dwell" stage (the amount of time the dialysate fluid is kept inside the abdomen). (See drain, fill and dwell.)
PERITONEUM: A thin membrane that stretches around the organs in the peritoneal cavity and holds them in place. It is also called the peritoneal membrane.
PERITONITIS: An infection of the peritoneal cavity. In peritoneal dialysis, it can be caused by bacterial contamination of the access site. This can be prevented by making exchanges carefully as taught by the dialysis care team.
PET: (See peritoneal equilibration test.)
PHOSPHATE BINDER: A medication that prevents the body from absorbing phosphorus in food. They help prevent bone disease in kidney patients.
PHOSPHORUS: A mineral found mainly in teeth and bones, which plays a role in how cells grow and use energy. Levels can become elevated with kidney failure and cause bone disease. A low-phosphorus diet and phosphorus binders help keep levels safe.
R
RED BLOOD CELLS: The cells that carry oxygen through the blood to all the tissues of the body.
S
SODIUM: A mineral found in table salt and many foods, especially packaged and processed foods. It causes the body to keep extra fluid, which may lead to swelling and increased blood pressure.
T
TOPICAL OINTMENT: A medical cream applied to the skin.
TRANSPLANTATION: An operation done to place a new organ, such as a heart, kidney, liver or pancreas from one person to another whose own organ has failed.
TRICARE: A type of health insurance coverage that is available to people who are active in or retired from military service. This program was formerly known as CHAMPUS.
U
UREA: A waste product of protein, normally removed from the body by the kidneys.
