Peritoneal Dialysis I: Introduction and Procedure

Peritoneal dialysis, or PD, is a treatment that utilizes the peritoneum as a natural filter to remove electrolytes, waste, and excess fluids from the blood.

A catheter about 24 inches or 60 cm long is inserted through the anterior abdominal wall into the peritoneal cavity.

It has Dacron cuffs that help secure the catheter and act as a barrier to prevent microorganisms from entering the peritoneum.

Over time, fibrous tissue grows around these cuffs, anchoring the catheter more firmly.

PD consists of three phases: inflow, dwell, and drain.

During the inflow phase, a dialysis solution, typically 2 liters, is infused into the peritoneal cavity over about 10 minutes.

The dwell phase lasts 4-6 hours, allowing the solution to absorb waste.

Finally, during the drain phase, the fluid is removed, taking 20-30 minutes.

In continuous ambulatory PD, each complete exchange typically takes 4 to 6 hours.

The choice of solution and volume depends on the patient's needs. Dextrose is the most common osmotic agent; however, alternatives like icodextrin and amino acids are also used.