This lesson covers:• The need for dialysis

• How peritoneal dialysis works

• How CAPD and APD work

It is important that you feel comfortable with the information and procedures you are learning during your training. Everyone has different ways of learning.

LESSON 1

Starting Peritoneal Dialysis

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Your need for dialysisThe kidneys clean the blood. They filter out waste products and balance body fluids.

When the kidneys stop working:

• Waste products build up in the blood

• Body fluids are no longer in balance

Lack of kidney function results in:

• Fatigue

• Weakness

• Loss of appetite

You need dialysis to replace some of the functions of healthy kidneys.

NOTES

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How peritoneal dialysis works

Peritoneal dialysis (PD) is a medical treatment.

• Waste products are filtered from your blood inside the body

• PD removes waste products and balances body fluids

Through a catheter placed in the abdomen, you exchange old PD solution for new PD solution. • The catheter is a small flexible tube

• The space in the abdomen is the peritoneal cavity

POINTS TO PONDER

How will having a catheter fit into your lifestyle?

What are some ways to help you adjust with living with a catheter?

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How peritoneal dialysis works

An exchange does the following:

• Removes old dialysis solution from the peritoneal cavity

• Replaces it with new dialysis solution

An exchange has 3 steps:

• Drain removes the old dialysis solution

• Fill replaces it with new dialysis solution

• Dwell is the period of time that the dialysis solution remains in the peritoneal cavity

Waste products and extra body fluid are removed when the old dialysis solution is drained.

NOTES

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Introducing the two types of PD Continuous Ambulatory Peritoneal Dialysis or CAPD and Automated Peritoneal Dialysis or APD, are 2 ways in which you can perform dialysis at home.

Your catheter provides a way to get the dialysis solution into and out of your peritoneal cavity.

Both CAPD and APD can be planned to fit your family, work, and personal lifestyle.

NOTES

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How CAPD works

CAPD is a manual form of PD.

CAPD is:

C–Continuous

A–Ambulatory

P–Peritoneal

D–Dialysis

CAPD means that you “exchange” old solution for new solution about four times every day. Dialysis is happening continuously.

The bag may be called a TwinBag.

• You will be trained exactly how to do an exchange

• There are 3 steps to do an exchange: DRAIN, FILL, DWELL

NOTES

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How APD works

APD is an automated form of PD.

APD is:

A–Automated

P–Peritoneal

D–Dialysis

• A machine does each exchange (drain, fill, dwell) usually at night, while you sleep

• During the day, you are free to go anywhere and be involved in your normal activities

• If you require an additional exchange during the day, your nurse will advise you

POINTS TO PONDER

Brainstorm the pros and cons of manual and automated PD.

What are some lifestyle considerations for each?

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Notes

Key points to remember• Your nurse will walk you through the

steps needed to do PD at home

• Feel free to take notes and ask your nurse questions throughout your training

• It is important for you to be comfortable with this information

• Be actively involved in the learning process

• As you continue your training, you will gain confidence to perform your therapy safely at home

• Both CAPD and APD can be planned to fit into your family, work, and personal lifestyle

• Know that you are an important part of your Renal Team

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My personalized action plan for doing dialysis at home will be:• Something I want to do

• Achievable

• Action specific

My goal is:

To meet my goal, I will:

Times per week/day:

Things I know will interfere with my plan:

How I’m going to deal with this:

I will report back to: when:

My confidence level that I can reach this goal is:(0-10 with 10 being very confident)

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Chapter review1) Two things failing kidneys no longer do well are remove waste products and excess fluid.

2) Both CAPD and APD use the dialysis solution in the peritoneal cavity to clean the blood.

3) CAPD is done manually.

4) APD is done automatically by a machine.

Answers: 1) True, 2) True, 3) True, 4) True

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

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Guide to new terms: Automated Peritoneal Dialysis - A type of PD where the blood is continuously being cleaned. Exchanges are usually done at night by a machine.

Continuous Ambulatory Peritoneal Dialysis - A type of PD where the blood is continuously being cleaned. Exchanges are usually done manually during the day.

A small flexible tube surgically placed in the abdomen that allows dialysate to move in and out of the peritoneal cavity.

The process of removing waste products from the blood artificially. It partially replaces the function of the kidneys.

Term to describe the steps of drain, fill and dwell in peritoneal dialysis.

The space inside your abdomen that holds the stomach, spleen, liver and intestines. The lining of this space is called the peritoneum.

The process of cleaning the blood by using the lining of the peritoneal cavity (peritoneum) as a filter. It is a type of dialysis that can be done at home.

The lining of your peritoneal cavity that filters waste products and fluid from your blood into the dialysate.

Peritoneum

APD

CAPD

Catheter

Dialysis

Exchange

Peritoneal Cavity

Peritoneal Dialysis

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LESSON 1

Sources

Khanna R, Nolph KD, Oreopoulos DG: The Essentials of Peritoneal Dialysis,

Kluwer Academic Publishers, 1993.

Thomas-Hawkins C, Zazworsky D. Self-Management of Chronic Kidney Disease. AJN. 2005; 105(10):40-48. Adapted from the Self-Management Support Patient Planning Worksheet by the organization Improving Chronic Illness (ICIC).

Stein, Andy, and Janet Wild. Kidney Failure Explained: Everything you always wanted to know about dialysis and kidney transplants but were afraid to ask. London, England: Class Publishing, 1999.

Note to the nurse:

This booklet for Starting Peritoneal Dialysis provides you with a guide to basic patient training and is part of the Patient First Educational Series. It is not intended to be the practice of medicine, nor does it replace sound medical / clinical judgement. Please use the space designated by “notes” to individualize this guide for each patient.

Thank you to those centres who helped put this material together.

LESSON 1

Provided by Baxter Corporation as a service to healthcare professionals and their patients.

Baxter CorporationMississauga, Ontario L5N 0C2

www.baxter.caBaxter is a trademark of Baxter International Inc.

PD-PF-01 (CAMP/MG1/16-0003) 2/16

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