Treating Kidney Failure With Peritoneal Dialysis

I.   Introduction

The People Like Us, Online series has been produced by the National Kidney Foundation to tell you about kidney failure and its treatment and to help you make the best treatment choices. The other parts of the series are:

As you go through each part of the series, you’ll be introduced to some medical terms that may be new to you. You can click to the meaning of each of these new terms in Words You Need to Know.

It is our hope that you’ll use this series as a springboard for discussions with your doctor and other members of your health care team and with your family. The better informed patients and their families are, the better the outlook for successful long-term treatment and quality of life for patients.

Two types of treatment are available for kidney failure: dialysis and transplantation. In addition, two different forms of dialysis can be done: hemodialysis and peritoneal dialysis, or PD. This part of the series is about PD and will tell you about:

The decision about which type of treatment is best for you depends on a number of factors, including:

Here’s what two patients who chose peritoneal dialysis said about their choice:

"I'm pleased with this treatment because it's given me more freedom. I've been able to do more traveling, and I have gone to the beach and various other places with my children and grandchildren."
--Jack
"One point is, this treatment is doable. The average person can do this and take care of his or her own health to a large extent--and not depend on a lot of people all the time, too. You're still connected to the dialysis center, but it's not a three or four times a week kind of thing."
--Mr. Smith

PD was the earliest form of treatment for kidney failure. It was first used in 1923, but did not gain wide acceptance until the 1970s. PD performs the same basic jobs as hemodialysis, but it differs from hemodialysis in how these jobs are done.

For instance, PD doesn't rely on an artificial kidney, or dialyzer, to filter the blood. Instead, PD uses the lining of your own abdominal cavity, also called the peritoneal membrane or the peritoneum, as the filter. Dialysis takes place inside your body and does not involve direct access to your blood. PD is a slow form of dialysis that takes place 24 hours a day rather than three times a week.

PD can also allow you a greater amount of freedom and flexibility. Instead of having to spend time traveling to a dialysis center three times a week, you can dialyze at home, at work, while traveling or during the night while you are asleep.

But PD does have its challenges. For instance, you have to do it every single day, seven days a week, 365 days a year. And you are totally responsible for sticking to your schedule. Also, you must be very careful about cleanliness. You can help to prevent infection by following the steps of PD exactly as you were taught and by keeping your space clean.

PD and hemodialysis differ in some other important ways. (To learn more about hemodialysis, see "Treating Kidney Failure With Hemodialysis" in this series).

Be sure to make note of information that is of special interest to you. Keep a list of questions you can take with you to your next visit with your doctor or other members of your health care team.

Remember, your goal is to choose a treatment you can live with. You want to feel good about your decision--the way Brandon, a teenage kidney patient, does:

"The way I look at it is this: If someone is nearsighted, they have to wear glasses to help them see. And if someone's born with poor hearing, they have to wear hearing aids. I was born destined to have chronic kidney disease, so I do dialysis. It's just something I have to do."