Hello, welcome to the University
of California San Diego Chronic Kidney Disease Program.
My name is Norma Reggev
and I'm a licensed clinical social worker.
Our healthcare team includes a nephrologist, pharmacist
nurse, social worker, and a dietician.
My role is to help educate patients learn
about kidney disease
and the treatment options available to them.
This is one module
of a six-part series discussing treatment options
for failing kidneys.
In this module, I will talk about peritoneal dialysis.
Our goal is to help empower you with knowledge to
make informed decisions about your kidney treatment choices.
We know that needing to consider kidney treatment
options can be a big decision.
It gives.
Some people hope to know
that there are treatments today that can help them
live long well and maintain a good quality of life.
Peritoneal dialysis is one of those options.
In addition to medications and dietary recommendations
your doctor will help you choose what treatment
option is best for you based
on your current health and treatment goals.
There are three main types of treatment for failing kidneys.
Those include transplant hemodialysis done
both in center and at home, and peritoneal dialysis
and finally, conservative management.
In this module, we will be discussing peritoneal dialysis.
When should I start dialysis?
Good question.
You and your kidney doctor will decide when to start based
on your labs kidney function, and
if you have severe symptoms caused by your kidney disease
such as shortness of breath, fatigue, swelling
muscle cramps, nausea, vomiting
or are having a metallic taste in your mouth.
Dialysis is a procedure used to treat kidney failure.
It does some of the things a normal kidney does
like removing extra water from the body
and removing the waste products that have built
up in the blood.
Peritoneal dialysis is one type
of dialysis treatment option.
Peritoneal dialysis uses a part of the body
as a blood cleaning filter instead of a machine.
The peritoneum is where dialysis occurs.
A thin lining called the peritoneal membrane
covers the space and acts as a dialyzer for your blood.
It is used to remove excess fluid
correct electrolyte problems
and remove toxins from the body.
Peritoneal dialysis can be done
either manually or with a cycler.
I will talk about each one of these in just a moment
but let's talk about access first.
Peritoneal dialysis access is done with a catheter.
A catheter is placed
into your abdomen through a surgical procedure.
A small portion
of the catheter will be outside of your body
but your clothing covers it when you're not using it.
With manual peritoneal dialysis
the patient performs the exchange without a machine.
A special fluid called ate is put
into the peritoneum and stays there for several hours.
Waste products and extra water move
through the peritoneal membrane into the ate.
Then the used ate is drained away
and replaced with fresh ate.
This is called the exchange.
Peritoneal dialysis is where a machine called
a cycler does your treatment overnight.
It does lots of exchanges at night while you're sleeping.
Some things to consider for this kind
of dialysis is that it allows
for more freedom during the day to do what you want.
It must be done for eight to 10 hours, and you
may also have to do a manual exchange during the day.
Here is Marilyn Hardy a peritoneal dialysis patient.
Well, my experience with peritoneal dialysis
I actually was about to go
on a trip to go see my granddaughter, who's eight years old
at that time, and I was at the getting ready to get
on the airplane and keep my kidney failed
so she gave me a choice for the peritoneal dialysis
or the other dialysis hemodialysis
because I wanted to still travel
so I got the peritoneal dialysis so
that I'd be able to st still be able to travel, and also
that the idea of doing it at home was more appealing
to me than going back to the basement in the hospital.
What have been some
of the difficulties with peritoneal dialysis?
It's not really been very difficult.
It hasn't been very difficult because I have a great team
of doctors that work with me at the clinic
and the hardest part is bringing those bags in every day
and every night and making sure that the site stay
my site stays clean so that I don't get infections.
I'm still able to get out
and garden and me and my mom go different places
and I have traveled with the, my suitcase.
They have a special suitcase for it, my machine, so yeah
I live a kind of normal life with the peritoneal dialysis.
Why did you choose peritoneal dialysis?
Being able to still see my grandchildren travel
with them or being able to watch 'em, babysit them.
Those are just my grandkids or everything I, and the idea
of being able to dialyze at night at home, other
than sitting in the basement at the hospital for three hours
and then when you come off the machines at the
at the basement, you're completely wiped out.
You can't do anything for the rest of the day.
Your days are just done the, it's not painful at all
because I don't cramp up like I used
to when I would do the other dialysis, I don't
I can sleep through it
because the cord is long enough where you can roll over
and I can sleep for the nine hours that I have to dialyze.
Sometimes I'll wake up in the middle
of the night because the machine's going off
but most of the time you can sleep through it.
Would you recommend peritoneal dialysis to other patients?
I think I've benefited from PD
because I'm able to hook myself up.
I don't have to go through all the pain.
I'm able to garden.
I'm able to go walk in with my mom.
I'm able to play with my grandkids.
I'm able to go on trips with my friends, small trips
because the larger ones, I'd have to mail my boxes.
PD is just, it's just been a much more freeing experience
than the hemodialysis is.
When you start peritoneal dialysis treatment
it is first done through manual exchanges.
They are usually done
for the first 30 days while you're learning.
Manual exchanges will also have to be done
if the electricity goes out.
It requires a clean place and takes about 30 minutes
per exchange after the first 30 days.
Cyr exchanges can be done at night while you sleep.
There are few things to consider about peritoneal dialysis.
Treatment is done daily, but flexible, allowing time
for other activities and for you to do it when you want.
It usually involves two clinic appointments per month.
The treatment is gentle, so it causes less discomfort.
Your exchange area must be kept clean.
You must wear a mask while doing your exchanges to
reduce the possibility of infection.
Your catheter and skin should be cleaned daily
and you will need space
for stored supplies that will be ordered for you
by your clinic and you will have less food
and fluid restriction in your diet.
We know that deciding on a treatment
for kidney failure is not an easy choice to make today.
We hope that you've learned a little bit more
about your option for peritoneal dialysis.
Congratulations, you've completed this module
on peritoneal dialysis.
Please check out our website
for additional educational modules in this series
on kidney failure and treatment options for failing kidneys.