It is an artificial method of cleaning & filtering of the blood and removal of excess fluid. Though it does not perform the full functions of the kidneys, patients who take recommended dialysis regularly remain relatively healthy and lead a near normal life.
There are two types of Dialysis – HD & PD
HD is conducted in a hospital. In this therapy the blood is taken out of the body and is passed through a machine for removal of waste and excess fluid. Cleaned blood goes back to the body. Normally this process takes about four hours and a patient has to undergo three such sessions in a week.
PD is conducted at home by the patient or his/her family members, in this therapy blood is cleaned within the body. Every person has a peritoneal cavity. The membrane of peritoneum cavity helps in cleaning the blood and removal of excess water from the blood. PD therapy does not require any equipment at home. In this process peritoneal dialysis fluid is infused into the peritoneum cavity. This fluid is kept in the peritoneum for 4 to 6 hours during which time, the waste product and excess fluid from the blood passes through the peritoneal and mixes with the fluid. This fluid is then removed from the body and fresh fluid is infused. The process of removal of affluent fluid (PD fluid mixed with waste products and excess fluid) and infuse of fresh PD fluid is called one exchange. Four such exchanges have to be performed every day. Each exchange takes 25 to 30 minutes only. The patient is free to carry on his/her normal life during the day except when doing exchange.
There are two types of PD – CAPD & APD
Ambulatory: Free movement- during dialysis patient is free to move around and carry out daily activities.
Peritoneal: It is a sack like membrane that lines abdominal cavity and cover most of the abdominal organs (refer image).
Dialysis: Dialysis removes waste products and excess water from blood.
CAPD is done manually, while a machine is used for APD. The patient is attached to a machine that cycles fluid in and out of the abdomen while the patient is asleep, usually over an 8 to 9-hour period. Often, fluid is left in the abdomen during the day. This type of dialysis allows freedom from exchanges during the day, APD is mostly used for patients who for some reason would find it difficult to do bag changes during the day.