Sabadell Hospital - Introduction

What is Peritoneal Dialysis?

He is one of the treatments available for the Renal insufficiency in its most advanced phase. It uses the peritoneal membrane (the membrane that covers the organs of the abdominal cavity) as a filter to purify excess accumulated toxic products and water in our body.

How Does Peritoneal Dialysis Work?

Through a flexible tube (catheter), placed in her abdomen, fluid is injected into the abdominal cavity. The fluid stays in the abdomen for a few hours, during which time the toxins and water that are left in your body pass from the blood to the fluid through the peritoneal membrane. After a few hours of treatment the "dirty" liquid is drained and a new one is infused.

Type of treatment with peritoneal dialysis

DPCA (Continuing Outpatient Peritoneal Dialysis)

You can do it in any clean room in your home.
You can do it at work or while traveling.
Requires 2 to 4 exchanges daily.
The abdomen will always be filled with fluid.

DPA (Automatic Peritoneal Dialysis)

A machine, called a cycler, performs the exchanges while you sleep.
Every day, when you go to bed, you just have to connect and the machine will perform the treatment.
The treatment usually lasts about 8-9 hours.
The machine can be carried in a suitcase.

Peritoneal catheter

What is the Peritoneal Catheter?

It is a flexible tube that is placed in the abdomen, around the navel, with a small surgical intervention. Connects the abdominal cavity or peritoneum with the outside. Makes it possible to easily connect to peritoneal fluid bag equipment for dialysis.

Catheter placement

Who places it

The nephrologist for puncture.
The surgeon for laparoscopy.

Preparation for the intervention

Joined the night before.
Necessary tests before any intervention (X-ray, analytical, anesthesiology visit ...).
Depending on the type of intervention, the anesthesia will be local or general.

Postoperative

Absolute rest 24 hours.
You can usually head home the next day.
Once at home you will need to rest for at least 1 more week.
You may need to take laxatives to prevent constipation.

Cures for the newly placed catheter

The following recommendations must be followed until complete cure of the wound from the operation (4 to 6 weeks):

Do not touch the dressing, you will be treated at the nephrology day hospital.
Make sure the catheter dressing is clean and dry (otherwise contact the nephrology team).
Avoid efforts that increase the pressure in the abdomen.
Do not shower or bathe, you will need to wash in parts so that the catheter is not wet.

Catheter Care

Prepare the room

Close doors and windows.
Close air conditioners and fans.
Mask for you and all the people inside the room.

Prepare the material

Hand sanitizer
Gases.
Physiological serum.
New dressing.
Roll roller coaster.

Put on the mask and remove the dressing from the catheter.
Wash your hands.
Wash the hole thoroughly with serum soaked in gauze.
Dry thoroughly with another gauze.
Attach a clean, dry tie gauze around the catheter.
Place the dressing and attach the catheter to the skin, using a small spatula to avoid "shaking".

Recommendations for the use of the catheter

The peritoneal catheter is an open door in your abdomen and it can become contaminated with infections. For this you need to take a number of precautions:

Mask and washing / disinfecting hands during connection, disconnection and during care.
Heal the hole whenever the dressing is dirty or damp.
Do not remove any shingles around the hole (they must jump by themselves).
Tighten the catheter well to avoid "shocks".
Avoid pressure on the outlet hole (belts, tight clothing ...).
Avoid bathtubs, public pools and rivers because water can contain bacteria.
A bag to protect the catheter is used for baths in the sea or in private pools.

Learning the technique

During the healing of the wound and catheter hole, it is used to perform the technique training. It will be the nurse who will take care and manipulate the catheter until you are properly trained. This period can last from 4 to 6 weeks.

Specifically, it will be held at the Nephrology Day Hospital. This is usually done 1 or 2 times a week, with the help of the Peritoneal Dialysis Nursing Team and doctors responsible for their treatment.

The peritoneal dialysis team will teach you everything you need to do the treatment at home (hygiene, care, how to exchange, dialysis data record, blood pressure taking, detection of possible complications ..., etc.).

Once you and your team of peritoneal dialysis professionals think you are qualified, you can begin treatment at home. From this point on, you will only need to go to the Peritoneal Dialysis Day Hospital for routine checkups (approximately every half and half).

You can contact the nephrology team by telephone, 24 hours a day, 365 days a year, in case of any doubt or incident.

Dialysis liquid

What is Dialysis Fluid?

Dialysis fluid is a sterile solution, such as a serum. Story:

some electrolytes (chloride, sodium, magnesium and calcium).
an osmotic agent (usually sugar), to help extract water.
a buffer substance (bicarbonate or lactate) to correct the acidosis that causes renal failure.

There are different types and compositions and different commercial houses. Your nephrologist will evaluate what fluid and how many bags you should use per day, depending on the results of your tests.

Precautions:

Check that we are using the correct bag.
If the bag is broken or expired, replace it with another one.
If the liquid in the bag looks different, throw it away.
Store the material in a dry place, out of direct sunlight.

Introduction to peritoneal dialysis

Peritoneal dialysis