Peritoneal Dialysis

What Is Peritoneal Dialysis?

Peritoneal dialysis is a medical treatment that uses the lining of the belly as a natural filter to take waste and extra water out of the blood. It can take over this job when the kidneys can't do it.

Why Do People Need Peritoneal Dialysis?

The main job of the kidneys is to clean the blood. They take out extra water and waste (things the body doesn't need). These leave the body as pee (urine).

When the kidneys don't work as they should, waste quickly builds up in the body and makes a person sick. When the kidneys stop removing enough waste and extra water from the blood, the person has kidney failure. Then, the person needs dialysis to clean the blood because the kidneys can't.

There are two types of dialysis: peritoneal dialysis (pair-eh-tih-NEEL dye-AL-ih-sis) and hemodialysis (hee-moh-dye-AL-ih-sis).

How Does Peritoneal Dialysis Work?

During peritoneal dialysis, a cleansing fluid called dialysate (dye-AL-uh-zate) goes into the belly. Waste and extra water seep across the lining of the belly into the dialysate, which then washes back out, bringing the waste and extra water with it.

Before starting peritoneal dialysis, kids need a soft, flexible tube (a catheter) placed into their belly. Doctors place the catheter while a child is asleep under general anesthesia.

Within 2 weeks, the surgical spot is healed and kids can start peritoneal dialysis treatments. Some may get the treatment earlier, if needed.

What Happens During Peritoneal Dialysis?

Peritoneal dialysis usually takes place at home. A caregiver (or the child or teen, if old enough) puts the dialysate into the body through the catheter. This can be done:

• by a machine that pumps the dialysate into the belly
• by hanging the solution above the body and letting gravity help the dialysate flow into the belly

As blood flows through the blood vessels in the belly, waste and extra fluid pass across the lining of the belly into the dialysate. Important things like blood cells and proteins are too large to pass through the lining and stay in the blood. After about an hour, the dialysis machine or gravity drains the dialysate out of the body through the catheter, taking the waste and extra water with it.

The dialysate washes in and out of the belly 8–12 times during each treatment. 

How Long Does Peritoneal Dialysis Take?

A peritoneal dialysis treatment takes about 8–10 hours. Most kids and teens get the treatments while they sleep each night.

Is Peritoneal Dialysis Uncomfortable?

There is some discomfort for a few days after the procedure to place the catheter. During the peritoneal dialysis treatments, your child should not feel any pain or discomfort. 

Are There Any Risks to Peritoneal Dialysis?

Peritoneal dialysis does have some risks, including:

• Infection. Rarely, germs can get into the body where the catheter goes into the skin and cause an infection.
• Hernia. Holding fluid in the belly for hours at a time can put stress on the stomach muscles. Sometimes the muscles get weak, which can lead to a hernia.

How Can Parents Help?

When kids need peritoneal dialysis, staying healthy helps them avoid problems and feel their best. Here are a few tips:

• Help kids eat a healthy diet. Kids on peritoneal dialysis need plenty of lean protein such as lean meats, fish, and beans.
• Help kids remember to take medicine if needed. Kids often need medicines to control their blood pressure, help produce red blood cells, and control nutrient levels in the blood. Follow the doctor's instructions, and ask before your child takes any nonprescription medicines, vitamins, or other supplements.
• Plan ahead. During travel, make sure you have everything you need to do treatments every day. If your child is on a special diet, find out ahead of time if you can get the foods you need. If not, take them with you. Dialysis requires planning, but it doesn't need to slow anybody down.
• Learn what to do. You and other family members will be trained to do peritoneal dialysis exchanges at home. You'll learn how to take care of your child's catheter and avoid infections or other problems.

What Else Should I Know?

Kids and teens who get peritoneal dialysis can go to school or work. Dialysis is done overnight, so kids can still stick to their usual schedule. Jobs and sports with lots of heavy lifting or contact may not be OK to do. But even with some limits, kids still can do many things they enjoy.

Kids will need regular checkups and blood tests about once a month.

Some people need dialysis treatments for the rest of their lives. If so, they might switch back and forth between peritoneal hemodialysis and hemodialysis, which is done in a special clinic called a dialysis center.