CAPD

There are two kinds of dialysis. In hemodialysis, blood is pumped out of your body to an artificial kidney machine, and returned to your body by tubes that connect you to the machine. In peritoneal dialysis, the inside lining of your own belly acts as a natural filter. Wastes are taken out by means of a cleansing fluid called dialysate, which is washed in and out of your belly in cycles.

A soft plastic tube (catheter) is placed in your belly by surgery. A sterile cleansing fluid is put into your belly through this catheter. After the filtering process is finished, the fluid leaves your body through the catheter.

Continuous Ambulatory Peritoneal Dialysis (CAPD)

Automated Peritoneal Dialysis (APD)

The basic treatment is the same for each. However, the number of treatments and the way the treatments are done make each method different.

CAPD is "continuous," machine-free and done while you go about your normal activities such as work or school. You do the treatment by placing about two quarts of cleansing fluid into your belly and later draining it. This is done by hooking up a plastic bag of cleansing fluid to the tube in your belly. Raising the plastic bag to shoulder level causes gravity to pull the fluid into your belly. When empty, the plastic bag is removed and thrown away.

When an exchange (putting in and taking out the fluid) is finished, the fluid (which now has wastes removed from your blood) is drained from your belly and thrown away. This process usually is done three, four or five times in a 24-hour period while you are awake during normal activities. Each exchange takes about 30 to 40 minutes. Some patients like to do their exchanges at mealtimes and at bedtime.

APD differs from CAPD in that a machine (cycler) delivers and then drains the cleansing fluid for you. The treatment usually is done at night while you sleep.

The type of peritoneal dialysis that is best for you depends on your personal choice and your medical condition. Your doctor will help you to choose the one that is best for you.

Some doctors feel that CAPD and APD have several benefits when compared to hemodialysis. With continuous dialysis, you can control extra fluid more easily, and this may reduce stress on the heart and blood vessels. You are able to eat more and use fewer medications. You can do more of your daily activities and it is easier to work or travel.

However, there are some people for whom peritoneal dialysis may not be appropriate. The abdomen or belly of some people, particularly those who are morbidly obese or those with multiple prior abdominal surgeries, may make peritoneal dialysis treatments difficult or impossible. Peritonitis (infection of abdomen) is an occasional complication although should be infrequent with appropriate precautions. When making a decision about the type of treatment, you should take into consideration that peritoneal dialysis is usually a daily process, similar to the working of the kidney and may be more gentle with fluid removal from the body. Peritoneal dialysis is an effective form of dialysis, has been proven to be as good as hemodialysis.

Peritoneal dialysis is not for everyone. People must receive training and be able to perform correctly each of the steps of the treatment. A trained helper may also be used.

Because your kidneys are not able to get rid of enough waste products and fluids from your body.

It is important that you have the right amounts of protein, calories, vitamins and minerals in your diet. Your dietitian will help you plan your meals to make sure that you get the proper balance. Here are some general guidelines:

Your body needs protein for growth, building muscles and repairing tissue.

After your body uses the protein in the foods you eat, a waste product called urea is left. Since your kidneys are not able to get rid of this urea, you may have too much in your blood. Dialysis and your diet are important to keep the urea level down.

Along with the clearing of urea, your body loses proteins that are normally retained in your blood. You will need to eat more protein to replace what is lost. The type of protein you eat is also very important. High quality protein should be eaten at each meal. It comes from animal sources such as eggs, fish, chicken and meat. Low quality protein needs to be limited in your diet. It comes from plant sources such as vegetables and grains.

Potassium is a mineral found naturally in foods that is dangerous when you have too much or too little. It is plentiful in dried fruits, dried beans and peas, nuts, meat, milk, fruits and vegetables and also in salt substitutes. Since both high and low levels of potassium in your body are dangerous to your heart, your potassium level will be watched closely.

Sodium is a mineral that is found naturally in foods and can affect your blood pressure. It is found in large amounts in table salt and in canned foods and processed meats (cold cuts).

With CAPD, you may be able to follow your usual diet. Watching your sodium can help to control your thirst and your weight gain. It may also lower your use of high-sugar solutions. Your doctor will choose the right dialysate for you to control your blood pressure and fluid level.

Phosphorus is a mineral present in all foods. It is found in large amounts in milk, cheese, nuts, dried beans and peas.

Eating foods high in phosphorus will raise the phosphorus in your blood and this can cause calcium to be pulled from your bones. This will make your bones weak and cause them to break easily. To help control the phosphorus in your blood, you may need to take medicine called a phosphate binder. It should be taken with your meals and snacks as ordered by your doctor. Your renal dietitian can also tell you about protein foods that are lower in phosphorus.

The dialysis treatment washes some water-soluble vitamins out of your body. If you are not getting all the vitamins and minerals you need from the foods you eat, vitamin and mineral supplements may be recommended. It is important to take only what is ordered for you. Certain vitamins and minerals can be harmful to persons on dialysis.