Continuous Ambulatory Peritoneal Dialysis

How Does CAPD Work? Procedure & Risk
Patients, who have a severe or chronic disease of the kidneys, can use a treatment known as peritoneal dialysis. One of the types of peritoneal dialysis for kidney failure is the CAPD or Continuous Ambulatory Peritoneal Dialysis while the other is APD or Automated Peritoneal Dialysis.

What is peritoneal dialysis (PD)?
In peritoneal dialysis, a sterile solution containing glucose (called dialysate) is run through a tube into the peritoneal and abdominal cavity around the intestine, where the peritoneal membrane acts as a partially permeable membrane. The peritoneal membrane or peritoneum is a layer of tissue containing blood vessels that lines and surrounds the peritoneal or abdominal cavity and the internal abdominal organs (stomach, spleen, liver, and intestines). Diffusion and osmosis drive waste products and excess fluid through the peritoneum into the dialysate until the dialysate approaches equilibrium with the body's fluids. Then the dialysate is drained, discarded, and replaced with fresh dialysate

This exchange is repeated 4-5 times per day; automatic systems can run more frequent exchange cycles overnight. Peritoneal dialysis is less efficient than hemodialysis, but because it is carried out for a longer period of time the net effect in terms of removal of waste products and of salt and water are similar to hemodialysis. Peritoneal dialysis is carried out at home by the patient, often without help. Hence patients are free from the routine of having to go to a dialysis clinic on a fixed schedule multiple times per week. Peritoneal dialysis can be performed with little to no specialized equipment (other than bags of fresh dialysate).

Will an access be needed for peritoneal dialysis?
Yes. Just as an access is needed for hemodialysis to remove blood from the body, an access is needed in peritoneal dialysis, too to instill a special solution into the abdominal cavity.

A Peritoneal Catheter is inserted by a relatively minor operation in the operation theatre. The special fluid is passed through this catheter to initiate dialysis.

How long does peritoneal dialysis last?
It has to be carried out 3-5 times per day, every day seven days a week, 365 days of the year. Each exchange lasts for less than one hour and dwell time (fluid kept inside the body) 4-6hrs.

Diet- A patient on dialysis will need to make changes in diet before and during dialysis treatment. These changes ensure that there is no fluid overload and that the right balance of protein, calories, vitamins and minerals are consumed. A diet that is low in sodium, potassium, and phosphorus may be recommended and the amount of fluids (in drinks and food) may be limited. A dietician will help prepare a diet plan to suit one’s tastes.

You should avoid fruits, fruit juice, coconut water, raw vegetables, dry fruits, nuts, spices, cocoa, chocolate and instant coffee. You will be prescribed a salt free diet as well. If you are a diabetic, you will also have to avoid sweets of all kinds, prepared with sugar or jaggery (gur). 

Food to be consumed: High protein food like dal, chicken, wheat, eggs and fish.

The nephrologist will also advise you to restrict your total daily liquid intake to about 400ml. This includes water, tea, coffee, soup, etc.

Do not hesitate to ask your nephrologist for dietary advice.

Vaccination schedule: Mandatory for all patients with kidney diseases and patients on dialysis

Intramuscular injection is given on non-dialysis days

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