Continuous Ambulatory Peritoneal Dialysis

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What is CAPD?

Continuous Ambulatory Peritoneal Dialysis or CAPD is a way of artificially removing the waste fluids and poisons from the body by your own abdominal membrane as a filter. During this process, a liquid called dialysate is put into your abdomen through a catheter which is a thin tube. The dialysate helps to pull our wastes, chemicals and any extra fluid from your blood through the peritoneum.

The peritoneum is the membrane lining in the cavity of the abdomen. It works as a filter when the wastes are pulled through it. The process of filling and emptying the abdomen with dialysate is known as exchange. Exchange can be 3 to 5 times in a day and one during the night. The entire process takes about 30 minutes.

Why do you need CAPD?

Continuous Ambulatory Peritoneal Dialysis is needed when your kidneys have failed or are not working well enough. The main function of your kidneys is to remove waste and any extra fluid from your blood with the help of urination. If your kidneys stop working, it can cause serious problems in your body. CAPD may be helpful if you have short term kidney failure or long term kidney failure. In case of short term kidney failure, CAPD may be needed until the kidneys get better whereas in case of long term kidney failure, dialysis exchanges will be needed for the rest of your life.

How is CAPD carried out?

With the help of a small operation, a soft tube called a catheter is inserted into your abdomen. A dialysis solution is then instilled through the catheter. The dialysis is performed by attaching tubing to the catheter that has two bags. One bag is a full bag of dialysis fluid and the other bag is an empty bag to drain out the old dialysis fluid with all the poisons. In this process, the fluid will always remain inside your abdomen for 4-6 hours during the day and 8-10 hours during the night for cleaning the poisons. You can have your dialysis with the fluid inside you and you will not feel the fluid while movement. The fluid that is removed will look like clear diluted urine and will be sterile and odourless.

How is the catheter put in?

A small procedure is done to place the catheter in. You will be given medicine that will help you relax and decrease pain. An incision will be made below your belly button or below your ribs, and through this hole, the catheter will be placed inside your abdomen. Your healthcare provider will put some liquid through the catheter to check if it is working well. The end of the catheter may be placed under your skin for 3 to 5 weeks and will be held in place with the help of stitches and the area will then be covered with bandages.

What are the side effects of CAPD?

CAPD is a gentle form of dialysis and it is unlikely that you may feel different before, during and after your exchanges. However, overtime, there is a possibility of your weight increasing due to the glucose in the dialysis fluid. You will also notice that your waist measurement will be larger than before due to the dialysis fluid in your abdominal cavity. This will get normal once your stomach muscles get used to having fluid inside them.

One complication of this dialysis is peritonitis. Peritonitis is an infection of the peritoneum which is the lining of your abdominal cavity. It is usually caused due to the poor technique used during your dialysis. While doing dialysis, it is important to remember to never take shortcuts. Peritonitis can be treated usually by injecting antibiotics into the new bags of fluid.