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Renal Replacement Therapies

Types of peritoneal dialysis

As we discussed, peritoneal dialysis involves fluid remaining and exchanging in your peritoneal cavity to help clean your blood and remove waste. This can be done through two types of peritoneal dialysis: Automated or Continuous Cycle Peritoneal Dialysis (APD, CCPD) and Continuous Ambulatory Peritoneal Dialysis (CAPD).

Automated or continuous cycle peritoneal dialysis (APD, CCPD)

In APD or CCPD, a machine called an automatic cycler performs exchanges every night while you sleep. In the morning, when you come off the machine, you begin with one exchange with a dwell time that lasts the entire day. In the evening, you connect to the machine to drain the fluid out of the body. CCPD allows you to continue with your daily activities with no interruptions of dialysis. However, it requires you to be attached to the machine for eight to ten hours. Certain people may need extra amount of dialysis to remove an adequate amount of excess water and waste.

                                                                   

Continuous ambulatory peritoneal dialysis (CAPD)

In CAPD, you do not use a machine to fill and drain the dialysate fluid. Using gravity, you are able to fill and empty your abdomen yourself, without the use of a machine. To complete CAPD, you must be sitting with dialysis solution above waste level to allow the dialysate to flow into the peritoneal cavity. Normally, 2-3 liters of dialysis fluid dwells in your peritoneal cavity for 4-6 hours. After the dwell period, with the help of gravity, the waste filled fluid is removed from the body. Placing the collection bag below waist level helps drain the solution out of the body.

An exchange is usually done four times a day by draining out the old fluid and refilling your peritoneal cavity with fresh fluid. The exchanges are done regularly throughout the day often early in the morning, lunchtime, late in the afternoon, and at bedtime. Each exchange takes about 30 to 45 minutes. During this time you are able to perform daily functions like eat meals or get ready for bed.