Kidney Health

Peritoneal Dialysis: A Treatment for Kidney Disease

Summary & Participants

As little as 40 years ago, a diagnosis of total kidney failure meant that death would soon follow. But thanks to major advances in medical technology, patients with kidney failure are living longer and healthier lives. Join our panelists as they discuss a life saving medical procedure called peritoneal dialysis.

Medically Reviewed On: June 19, 2008

Webcast Transcript

LEONARD STERN, MD: With any form of dialysis, we need an access. In hemodialysis there is a blood access. In peritoneal dialysis the access is a tube called a Tenckhoff catheter, Tenckhoff named after the surgeon called Henry Tenckhoff, who invented this in 1969, and the tubes are generally placed by surgeons in the abdominal cavity. The tube is in potential space, because ordinarily our abdominal cavity is only filled with intestines. But this catheter is left in place, and the outside part can be connected through a series of specialized connectors to bags of rinsing fluid, and a rinsing solution is connected and it flows into the abdominal cavity, where it stays for a period of time and acts as a collector for waste products. The membrane can act as a barrier, and the waste products travel across the membrane into this fluid compartment, where they're retained, and after a few hours of time, this fluid is drained out -- it essentially becomes urine equivalent -- and then fresh fluid is placed in.

Typically, the exchange of draining the fluid out and adding new fluid takes about 30 to 45 minutes, and an average schedule for a normal person might be four to five exchanges per day, generally spaced out at four- to six-hour intervals.

LISA CLARK: Now, you're talking about CAPD, right?

LEONARD STERN, MD: Correct. That's the manual form of treatment.

LISA CLARK: Let me get the exact right name of it. That is the continuous ambulatory peritoneal dialysis?

LEONARD STERN, MD: Right, nicknamed that because the concept is that after the patient does the exchange they're not confined to bed. They can be ambulatory. The original name for it, though, was continuous equilibration peritoneal dialysis, because the fluid in the cavity equilibrates with the body compartment. That means that all the waste products are removed at a very high concentration. So it's a very reasonable way to eliminate waste products and fluid.

LISA CLARK: Let me reiterate. Does the patient have to remain quiet or sitting still during this process, or not?

LEONARD STERN, MD: Well, it's a sterile procedure, so during the drainage of the fluid and the entry of the new fluid, it's a sterile technique that the patient is taught by trained nurses, so they don't necessarily have to sit still, but it's time-consuming, taking 30 to 45 minutes.

LISA CLARK: How many times a day?

LEONARD STERN, MD: An average schedule is four to five times a day for the manual mode, largely dependent on the size of the person. The bigger you are, unfortunately, the more exchanges. The smaller you are, the less exchanges. The volume also varies based on the size of the patient. The larger the patient, the larger the volume.

LISA CLARK: Right. Now, there's also something called CCPD, continuous cycling peritoneal dialysis. How does this option work?

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