Hospital of Sabadell

Introduction to peritoneal dialysis

Peritoneal dialysis

What is peritoneal dialysis?

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

How Does Peritoneal Dialysis Work?

Through a flexible tube (catheter), placed in our abdomen, fluid is injected into the abdominal cavity. The fluid stays in the abdomen for a few hours and during this time the toxins and water that are left in our 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.

Types of treatment with peritoneal dialysis

DPCA (Continuing Outpatient Peritoneal Dialysis)

  • You can do it in any clean room in your house.
  • You can do it at work or while traveling.
  • Requires 2 to 4 exchanges daily.
  • Your abdomen will always be full of fluid.

 

DPA (Automatic Peritoneal Dialysis)

  • A machine, called a cycler, performs the exchanges while you sleep.
  • Every day, at bedtime, you just need 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, at the level of the navel, with a small surgical intervention. It communicates the abdominal cavity or peritoneum with the outside. Makes it easy to connect to peritoneal fluid bag equipment for dialysis.

Catheter placement

Who places it

  • The puncture nephrologist.
  • The surgeon by laparoscopy

Preparation for the intervention

  • I entered last night.
  • Necessary tests before any intervention (X-ray, analysis, anesthesiology visit, etc).
  • Depending on the type of intervention, the anesthesia will be local or general.

Postoperative

  • Absolute rest for 24 hours.
  • Generally at 24h you can go home.
  • At home you should rest for at least another week.
  • It may be necessary to take laxatives to prevent constipation.

Care for the newly placed catheter

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

  • Do not touch the dressing, they will perform the cure in the day hospital.
  • Ensure that the catheter dressing is clean and dry (otherwise contact the nephrology team).
  • Avoid making efforts that increase pressure in the abdomen.
  • Do not shower or bathe, you must wash the parts to avoid getting the catheter wet.

Catheter care

Prepare the room

  • Close doors and windows.
  • Close air conditioners or fans.
  • Mask for you and everyone in the room.

Prepare the material

  • Hand sanitizer
  • Gauze.
  • Physiological serum.
  • New dressing.
  • Roll-up screwdriver.
     

 

  1. Put on the mask and remove the dressing from the catheter
  2. Handwashing.
  3. Lavar well the orificio with gauze soaked in serum and then secarlo bien con otra gauze.
  4. Place a clean, dry tie gauze around the catheter.
  5. Place the dressing.
  6. Attach the catheter to the skin with a little scarf to prevent pulling.

Recommendations on the use of the catheter

The peritoneal catheter is an open door to your abdomen and can become contaminated by causing infections. That is why you must take a number of precautions:

  • Mask lavado y / Desinfección Manos during the connection, disconnection and to perform the cure.
  • Heal the hole whenever the dressing is dirty or wet.
  • Do not remove any scabs around the hole (they should jump alone).
  • Well to avoid the subject catheter pull.
  • Avoid pressure on the exit orifice (belts, tight ropa ...).
  • Avoid bathtubs, public pools and rivers because water can contain bacteria.
  • For bathing in the sea or in private pools a bag is used to protect the catheter.

Learning the technique

Sleep duration of the healing of herido proceso y orificio of the catheter, it Aprovecha to perform the Training of technicians. It will be the nurse who heals and manipulates the catheter until you are properly trained. This period is 4 to 6 weeks.

More exactly, it will make the day hospital peritoneal dialysis. This is usually done 1 or 2 times a week, with the help of the peritoneal dialysis nursing team and the doctor responsible for their treatment.

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

Once you and peritoneal dialysis PROFESSIONALS believe is qualified, you can start in your tratamiento domicilio. From that point on, you will only need to go to the Peritoneal Dialysis Day Hospital for routine checks (approximately every month and a 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 fluid

What is dialysis fluid?

Dialysis fluid is a sterile solution, such as a serum. This compuesto por:

  • some electrolytes (chloride, sodium, magnesium and calcium).
  • an osmotic agent (Generally azúcar) To help extra 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 daily depending on the results of your tests.

Precautions:

  • Check the bag utilizando that we are correct.
  • If the bag is broken or expired, replace it with another.
  • If the fluid in the bag looks different, throw it away.
  • Store the material in a dry place, away from direct sunlight.