Kidney failure, or 'kidney failure', is something that scares anyone. Many people think that after that, they will have to go to hospitals for the rest of their lives to have their blood cleaned. But did you know that there is a special dialysis method that you can do from home, along with your daily activities? That's what we call Peritoneal Dialysis. Today, we will talk about this simply, in a way that you can understand.
Simply put, what is Peritoneal Dialysis?
Think of your kidneys as two super filters. Their main job is to filter out unwanted waste products and excess water from the blood. We call the liquid that is filtered as urine. But when the kidneys fail, this filter does not work properly. Then waste products and toxins start to accumulate in the blood. We call this condition ``uremia``. If left untreated, this can be life-threatening.
That's when dialysis treatment comes in. Peritoneal dialysis is one such type of dialysis. But something very strange happens in this one. In this one, we use a natural filter in your body to clean your blood. That is the thin membrane that surrounds the organs inside your abdomen. In medicine, we call this the peritoneum.
Before starting this treatment, a doctor will perform a small operation and insert a very thin, soft tube (catheter) through the skin of your abdomen. Then, through the tube, a special sterile fluid (we call it ``dialysate'') is sent into your abdomen. While this fluid is in your abdomen for several hours, the peritoneal membrane absorbs the waste products and excess water from the blood into this fluid. Then, the waste-filled fluid is removed through the same tube, and new fluid is put in again. You can do this procedure at home, several times a day, or even while you are sleeping at night.
There are two main methods for this.
Peritoneal dialysis is mainly done in two ways. You can choose the method that is most convenient for you by talking to your doctor.
| Treatment method | How to do it and special points |
|---|---|
| Continuous Ambulatory Peritoneal Dialysis (CAPD) (Do-it-yourself method during the day) | No machine is used in this. You have to change the fluid yourself about 3-5 times a day. It takes about 30-40 minutes each time. While this fluid is in your stomach, you are free to do your work as usual. |
| Automated Peritoneal Dialysis (APD) (Overnight machine method) | This uses a small machine (an `automated cycler`). When you connect it to the machine before you go to bed at night, the machine will automatically inject and withdraw the fluid as many times as needed throughout the night. The treatment is complete when you wake up in the morning. Many people prefer this method because there are no interruptions during the day. |
But why is this method not so popular?
Despite its many advantages, it is less commonly used than the hospital-based method of hemodialysis. There are several reasons for this:
- Lack of awareness: Many patients, and sometimes even medical staff, are not fully aware of this option.
- Lack of trained staff: There are few doctors and nurses who have received special training in this treatment.
- Problems that arise in an emergency: If a person's kidneys suddenly fail, not all hospitals have the facilities to insert this tube (catheter). In such a case, they have to resort to hemodialysis, which can be easily started.
- Difficulty finding someone to help: Some people find it difficult to do this alone. In times like these, finding someone to help can be a challenge.
What are the advantages of this method?
The biggest advantage of this is the freedom and convenience you get. You don't have to confine your life to a hospital.
- Convenience and flexibility: You don't have to go to the hospital. You can do this in a clean place, whether it's at home, at work, or while traveling.
- No major restrictions on food and drink: There are fewer restrictions on food and drink than other dialysis methods. Because waste products are removed from the body almost daily, the amount of waste that accumulates is less.
- No need for needles: During dialysis at the hospital, needles are required every time. This is a big relief for someone who is afraid of needles.
Aren't there disadvantages and risks?
As with any medical treatment, there are risks and disadvantages, and it is important to be aware of them.
| Risk / Disadvantage | Simply put... |
|---|---|
| Peritonitis | This is the most common risk. Germs can enter the peritoneum lining of the abdomen through the tube or through dirt, causing an infection. It is essential to be very careful about cleanliness. |
| Hernia | A hernia can occur due to the pressure created when fluid fills the abdomen. |
| Weight gain | Because the liquid used contains sugar (dextrose), some of it is absorbed by the body and can lead to weight gain over time. |
| Treatment ineffectiveness | After years of this treatment, some people may experience a decrease in the function of their peritoneal membrane, which may require switching to another dialysis method. |
| Must-do every day | This is something that needs to be done daily. It can be mentally taxing for some. |
Avoid these things.
If you are on peritoneal dialysis, be aware of these things:
- Do not use medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) that are harmful to the kidneys without consulting your doctor.
- Avoid swimming in unchlorinated water like ponds, rivers, and lakes, and avoid soaking in hot tubs. These are more likely to introduce germs. However, there is no problem with taking a shower daily.
When should you see a doctor immediately?
If you are receiving this treatment, do not ignore any of the following symptoms.
- Severe stomach pain or bloating
- If you feel like you have a fever
- If the heart rate is fast (tachycardia)
- Difficulty breathing (dyspnea)
- Nausea and vomiting
- If the fluid you drain from your stomach is cloudy or a different color than usual (this could be a sign of infection)
- Symptoms of low blood pressure (hypotension), such as dizziness and lightheadedness
If you see any of these signs, call your treating doctor or clinic immediately, or go to the nearest hospital Emergency Department (ETU).
Ultimately, you and your doctor should decide together whether Peritoneal Dialysis or Hemodialysis is best for you. Your health condition, lifestyle, and your preferences should all be taken into consideration to make the best decision.
Take-Home Message
- Peritoneal dialysis is a highly effective treatment method that can be performed at home with greater freedom for patients with kidney failure.
- Cleanliness is number one in this treatment. Always wash your hands and do this in a clean environment. This can help prevent serious infections like Peritonitis.
- Be well aware of the advantages, disadvantages, and risks of this method. If you have any concerns, don't hesitate to talk to your doctor.
- Always seek your doctor's advice to choose the dialysis method that best suits you.
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