What is Peritoneal Dialysis?
Peritoneal dialysis (PD) is a treatment for kidney failure that uses the peritoneum, a membrane lining the abdominal cavity, to filter waste and excess fluid from the blood. During PD, a cleansing fluid called dialysate is introduced into the abdominal cavity through a surgically placed catheter. Waste products and extra fluid move from the blood, through the peritoneal membrane and into the dialysate fluid due to diffusion and osmosis. The used dialysate is then drained from the body and replaced with fresh dialysate. This cycle is repeated several times per day or continuously during sleep with an automated PD machine.
How does PD work?
There are two main types of PD - Continuous Ambulatory Peritoneal Dialysis (CAPD) and automated peritoneal dialysis (APD). With CAPD, the patient performs 4 exchanges of dialysate fluid manually per day. The patient uses a sterile connection to infuse 2 liters of dialysate into their abdomen through a catheter. It dwells for 4-6 hours while waste filters from the blood into the dialysate. Then the used dialysate is drained out and replaced with fresh dialysate. The entire process takes 30-45 minutes to complete one exchange. APD uses a machine that automatically infuses and drains dialysate during sleep, with the option for additional daytime exchanges. This allows for continuous overnight dialysis with fewer manual exchanges than CAPD.
Benefits of Home Peritoneal Dialysis
One major advantage of Peritoneal Dialysis is that it can be performed at home, allowing patients to receive treatment without having to go to a dialysis center 3 times per week. This offers greater flexibility and freedom since treatments can be integrated into daily life and work schedules. Patients can travel and be away from home more easily on PD compared to hemodialysis, which requires frequent clinic visits. PD also avoids the need for vascular access like arterio venous fistulas or grafts used in hemodialysis. There is no need to restrict fluids as much as hemodialysis. PD tends to have fewer dietary restrictions as well. For some, the manual nature of exchanges with CAPD provides a sense of control over their treatment.
Catheter Placement and Risks
To start PD treatments, a surgeon will place a flexible tube called a catheter into the patient's abdomen during a short procedure. One end of the catheter resides inside the abdomen and the other end exits the skin, allowing connection to bags of dialysate fluid. The most common location is the lower abdomen, just above the pubic bone. While long-term catheters have reduced risks, complications can potentially occur with placement or long-term use like exit site or peritoneal infections, hernias, or leaks. Catheters may also require replacement every 1-2 years. Strict sterile technique is needed during exchanges to prevent infections.
Impact on Quality of Life
Overall, most patients on PD report a fairly good quality of life comparable to hemodialysis according to research studies. Many appreciate the freedom and flexibility it allows, though managing daily treatment can also impact personal and family routines. Some challenges include fatigue or discomfort from the manual nature of exchanges, dietary and fluid restrictions, storage and transportation of dialysis supplies, and risks of peritonitis. The ability to work or attend social activities may depend on individual schedules and ability to complete needed dialysis. Support from family and caregivers can help manage s of home therapy. Ongoing medical and nursing oversight is crucial for monitoring PD prescriptions and addressing any issues.
Automatic Peritoneal Dialysis as an Alternative
For patients who struggle with CAPD exchanges or fluid restrictions, automated PD with machines like automated cyclers offers an alternative. APD cycles are integrated overnight while patients sleep, freeing up time for daytime activities. Machines automatically infuse fresh dialysate and drain used fluid from the abdomen based on programmed cycles. Some models also offer daytime cycles. This continuous dialysis during sleep helps achieve optimal fluid removal and clearance of waste toxins. Monitoring systems on cyclers enhance treatment adherence and allow medical staff to remotely track therapy data. While APD still requires manual fluid exchanges during the day, this hybrid format provides better dialysis coverage with less impact on daytime schedules. Further research continues to develop easier and more convenient home therapies.
Considerations in Choosing Peritoneal Dialysis
For those with kidney failure, PD can represent an attractive dialysis option that offers independence. However, it still requires a major lifestyle adjustment. Peritoneal dialysis suitability depends on factors like medical comorbidities, physical ability to perform exchanges, vision or dexterity issues, and support at home. Adequate training is imperative to safely manage catheter and supplies. Ongoing connections with the treatment team are also important for promptly addressing any dialysis issues or catheter complications early on. With proper selection, education and follow up, PD therapy can effectively sustain life quality for end stage renal disease patients. Ultimately, an individualized discussion with a nephrologist can help determine the best renal replacement therapy in each unique case.
As a renal replacement modality for kidney failure, peritoneal dialysis provides an alternative form of dialysis that can be performed in the home setting. While it requires commitment and lifestyle modifications, PD often allows greater flexibility and independence compared to in-center hemodialysis. Continuous evolution of PD equipment and techniques also seeks to alleviate treatment burdens. When appropriate patients are selected and properly trained, peritoneal dialysis can successfully sustain life and quality of life for those living with end stage kidney disease. Ongoing management remains crucial for ongoing therapy successes.
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Resources
What Are the Innovations in Peritoneal Dialysis Systems and How Are They Transforming Patient Care?
What Are the Challenges and Solutions for Patient-Centered Care in Peritoneal Dialysis?
What Are the Key Differences and Benefits of Peritoneal Dialysis and Hemodialysis?
What Are the Key Developments in the Peritoneal Dialysis Market?
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The Global Peritoneal Dialysis Market is forecasted to be worth USD 5.73 billion by 2027, according to a new report by Emergen Research.
The key factors influencing the market include higher incidences of kidney diseases, lifestyle diseases & chronic diseases that affect the function of the kidneys of removing the waste product from the blood.
Technological advancement in healthcare equipment & diagnosis solutions and higher investment in the healthcare systems are some of the supplementary factors that help drive the market growth.The latest research report by Emergen Research, named ‘Global Peritoneal Dialysis Market - Forecast to 2027’, entails a comprehensive review of the global Peritoneal Dialysis market’s present and future trends.
The report gathers viable information on the most established industry players, sales and distribution channels, regional spectrum, estimated market share and size, and revenue estimations over the forecast timeframe.Get a sample of the report @https://www.emergenresearch.com/request-sample/161 Market Scope:One of the report’s central components is the broad Peritoneal Dialysis market segmentation that includes the product type gamut, application spectrum, end-user industry landscape, significant geographical regions, and the top market contenders.
The report contains unbiased industry expert opinions on the current market scenario, past market performance, production & consumption rates, demand & supply ratio, and revenue generation forecasts over the estimated period.
The key players’ financial positions, along with their gross profits, sales volumes, sales revenue, manufacturing costs, and other financial ratios, have been accurately gauged in the report.Further key findings from the report suggestIn June 2019, Baxter International Inc. revealed its planning for higher investment in its manufacturing of peritoneal dialysis (PD) technologies situated in the United States.
