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Peritoneal Dialysis Treatment for Kidney Failure

Peritoneal Dialysis is an ideal way for people to remove waste products from blood when their kidneys are no longer able to adequately perform the job. Blood vessels in the peritoneum or abdominal lining fill in for kidneys with help of dialysate fluid which flows into & outside of peritoneal space. Peritoneal dialysis essentially differs from hemodialysis which is one of the most commonly used blood-filtering procedures. However, peritoneal dialysis is a convenient procedure where patients can treat themselves at home, or at work or even during travel. Moreover, patients may also be able to use fewer medications & eat a less restrictive diet as well than they would need to do with the hemodialysis procedure. Nevertheless, peritoneal dialysis is not the best option for everyone. Peritoneal dialysis patients will require manual dexterity & ability to take care of themselves at home or under a reliable caregiver.

Peritoneal Dialysis

Why Undergo Peritoneal Dialysis?

Peritoneal dialysis is usually done so as to manage kidney failure until the possibility of kidney transplant matures. However, kidney failure itself results from chronic disease which causes damage to kidneys over a number of years.

Common Causes of Kidney Failure Include the Following

Doctors can always help patients decide as to which type of dialysis will work best for them, & where should they be starting, based upon the factors listed below.

  • Overall health of the patient
  • Function of the kidneys as measured by urine & blood tests
  • Personal preferences of the patient
  • Home situation of the patient

Peritoneal Dialysis is an Ideal Option for Patients in the Following Conditions

  • When they cannot tolerate rapid changes of fluid balance which is normally associated with hemodialysis. Blood is typically pumped into a machine in order to be filtered & subsequently returned to the patient’s body during hemodialysis.
  • When patients want to minimize disruption of daily activities & look forward to more convenient ability to work or travel.

Peritoneal Dialysis Will Not Work for Patients in the Following Conditions

  • Patients having extensive surgical scars in abdomen
  • Patients with large abdominal hernia
  • Patients having limited ability to care for themselves
  • Patients lacking care-giving support at home
  • Patients having inflammatory bowel disease
  • Patients having frequent bouts of diverticulitis

Risks & Complications Associated with Peritoneal Dialysis

Most people needing peritoneal dialysis also face a variety of serious health issues including diseases which cause kidney failure or kidney failure itself. Peritoneal dialysis however prolongs life for many patients, but life expectancy of those who require this procedure is still lower than that of people who do not require dialysis.

Main complications of peritoneal dialysis include the following.

  • InfectionsPeritonitis is the most common problem associated with patients undergoing peritoneal dialysis. It is an infection of the lining of peritoneum or abdominal cavity. This infection can also develop at the site where catheter tube is inserted & which carries the cleansing fluid into & outside of the patient’s abdomen.
  • Weight GainFluid which is used to clean the patient’s blood in peritoneal dialysis contains dextrose or sugar; whereby patients may take in several hundreds of calories each day by absorbing some of this which is known as dialysate. This may eventually result in weight gain. These extra calories may also lead to high blood sugar, especially when the patient is suffering from diabetes.
  • Hernia – Weakening of Abdominal MusclesAs holding fluid in stomach for long periods can strain peritoneal dialysis patient’s belly muscles, hernia or weakening of abdominal muscles is quite possible.

Preparing for Peritoneal Dialysis

  • Patients will receive training on what this procedure involves & as to how the equipment should be handled prior to starting peritoneal dialysis. Moreover, patients will also need to undergo a surgical operation so as to insert the catheter, which is a thin, soft plastic tube which carries the peritoneal dialysis solution inside & outside of the patient’s abdomen. Patients for this purpose may receive general or local anesthesia for initial surgical insertion. Surgeons usually place this tube near the patient’s belly-button.
  • After insertion of the catheter, doctors usually recommend that patients wait for at least a fortnight for the catheter site to heal before commencing peritoneal dialysis treatment.

Peritoneal Dialysis Treatment Procedure

A sterile cleansing solution called dialysate flows through the catheter into the patient’s abdomen in peritoneal dialysis procedure. This solution eventually stays within the abdomen of the patient for a prescribed period of time which is known as the dwelling time. During the dwell time, chemicals, wastes & extra fluid in patient’s blood pass from capillaries or tiny blood vessels in the lining of peritoneum or abdominal cavity, into the dialysate solution. This solution happens to contain sugar which draws wastes & extra fluid through capillaries in peritoneum into the patient’s abdomen. Belly may however feel fuller than usual when dialysis solution is present there, but is generally not so uncomfortable. After passage of dwell time, dialysate solution along with waste products is drawn from blood & excessive fluid which drains into a sterile bag for collection. The entire process of filling & subsequently draining the patient’s abdomen is known as an exchange. Different techniques of peritoneal dialysis have differing schedules of daily exchanges. The most common two main schedules are CAPD – Continuous Ambulatory Peritoneal Dialysis & CCPD – Continuous Cycling Peritoneal Dialysis. However, some patients also use a combination of both these methods.

  • CAPD – Continuous Ambulatory Peritoneal DialysisPatients will fill their abdomen with dialysate solution & later drain the fluid in this type of peritoneal dialysis procedure. Gravity however helps to move the fluid through the tube into & outside of the patient’s belly. Every exchange includes filling the patient’s abdomen with dialysis solution, then allowing this fluid to dwell inside the abdomen & finally letting the fluid drain out of the peritoneum. Patients may require 3 – 4 exchanges during each day & one specifically with a longer dwelling time while they sleep. Patients can also do these exchanges at home, at work or at any clean place. Moreover, they are free to go about their normal activities while the dialysate solution dwells within their abdomen in-between exchanges.
  • CCPD – Continuous Cycling Peritoneal DialysisAlso known as APD or Automated Peritoneal Dialysis, there is an involvement of a machine called automated cycler in CCPD which performs 3 – 5 exchanges at night while the patient is sleeping. The cycler is designed to automatically fill the patient’s abdomen with dialysate solution & allow it to dwell there before draining it outside into a sterile drainage bag which the patients must empty every morning. CCPD procedure also allows more flexibility to patients during the day, but they must however remain attached to the machine for about 10 – 12 hours at night time. Moreover, every morning they must begin with one exchange allowing dwell time which will last throughout the entire day. Fortunately, they are not required to be connected to the machine during the day time.

The ideal type of peritoneal dialysis which is best suited for the patients depends upon their personal preferences, lifestyle & associated medical conditions. Moreover, patients can also customize their dialysis program by combining these two forms to suit their requirements. For instance, patients using CCPD may perform one extra exchange in afternoon so as to remove more waste & also prevent any absorption of too much fluid.

Peritoneal Dialysis Treatment Results

Several factors influence how well peritoneal dialysis works for patients in removing extra fluid & wastes from their blood. Some of these factors are listed below.

  • Size of the patient
  • Peritoneal Transport Rate – how quickly is peritoneum able to filter waste
  • Fill Volume – how much dialysate solution the patient is able to use
  • Number of daily exchanges
  • Duration of dwell times
  • Concentration of dextrose (sugar) in dialysis solution

Associated Caring & Tests with Peritoneal Dialysis

Peritoneal dialysis healthcare team will perform several tests so as to check if the dialysis of patient is able to remove enough waste products generated by the body. These tests some of which are performed during the first week of peritoneal dialysis help determine whether the patient is receiving adequate dose or amount of dialysis.

  • PET or Peritoneal Equilibration TestPET test measures as to how much sugar has been absorbed from a bag which was utilized as dialysate solution. It will also measure the amount of urea & Creatinine, the two waste products, which are present in the solution after a four hour exchange session.
  • Clearance TestSamples of venous blood & used dialysate solution are collected so as to compare the amount of urea present in the used solution with the amount in blood. In case patients still produce urine, doctors may take a urine sample at the same time in order to measure urea concentration.

In case these test results show that peritoneal dialysis schedule is not able to remove enough wastes, doctors may alter the routine of dialysis. This change may involve altering the number of exchanges, increasing the amount of dialysate solution patients have been using for each exchange or by using a dialysate solution featuring a higher concentration of dextrose.

Patient Contribution for Improving Peritoneal Dialysis Results

Patients on their part can improve peritoneal dialysis results & overall health by consuming the right type of foods including foods which are low in phosphorous & sodium. Dieticians can also help patients develop individualized meal plans which are based upon their body weight, personal preferences, remaining kidney function & associated medical conditions like high blood pressure & diabetes. Taking prescribed medications in time is also important for obtaining the best possible results from peritoneal dialysis treatment. Patients are also most likely to require various medications in order to stimulate production of red blood cells, control blood sugar, control levels of certain nutrients in blood & prevent buildup of phosphorous in their blood.

Affordable Peritoneal Dialysis Treatment in India

Peritoneal dialysis is one more way to remove waste products from blood when kidneys are no longer able to do an adequate job. India, which has emerged as an ideal global medical tourism hub providing a wide spectrum of high quality but low cost healthcare solutions including hemodialysis & peritoneal dialysis treatments for kidney failure to people from all around the world, is a sensible choice. IndiaMedTrip which is associated with the top doctors, surgeons & hospital facilities is one of the leading medical tourism company based in South Asia offering a range of affordable medical solutions to international patients. IndianMedTrip services begin with the first telephone conversation & progress to assist in finding the right doctor & hospital, obtaining medical visa, warm reception on arrival at airport, convenient travel, comfortable accommodation, scheduled appointments with doctors & treatment without any waiting period, choice of an exotic recuperative vacation, follow-up checks & a successful farewell.

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