Peritoneal dialysis

Definitions

Peritoneal Dialysis (PD)

The principle of peritoneal dialysis(PD) is similar to that of hemodialysis ,but in PD ,the patient’s peritoneum is used as the semipermeable membrane between capillary blood and dialysis fluid which is introduced into the peritoneal cavity through permanent catheter.

Intermittent Peritoneal Dialysis (IPD)

This mode of peritoneal dialysis ,alternate dialysis of various duration (10-48 hours) with interdialytic phases lasts for one or more days according to the patient needs. The exchange volume can be adjusted  according to patient’s size , volume of peritoneal cavity , and cardiopulmonary tolerance. Introduction of automated techniques (Cyclers and reverse osmoses machines) increased the safety by reducing risk of infection and also the effectiveness of PD by insuring the regularity of the exchanges

Nocturnal Peritoneal Dialysis (NPD).

Nocturnal Peritoneal Dialysis (NPD) is Intermittent Peritoneal Dialysis (IPD) performed nightly. The total exchange time in this mode of therapy is 8-10 hours using the cycle times up to 60 minutes. It is indicated in patient with increased membrane permeability (high peritoneal transfer rates) and those suffering from complications associated with increased intraabdominal pressure.

Continuous Ambulatory Peritoneal Dialysis (CAPD).

The basic principle of CAPD is a continuous presence of dialysate in the peritoneal cavity. The dialysis fluid is left in place for 6-8 hours and slowly equilibrates with plasma solutes in the peritoneal cavity. The fluid is then discharged in a plastic bag ,connected to the catheter, and the contents of new bag are introduced through the catheter. Increasing the osmolality of dialysis fluid by adding concentrated glucose (hypertonic) will increase the fluid loss. Three or four exchanges are required every day. The patient can undertake this treatment alone without machine. It has a lower cost than HD and with better hemodynamic stability.

Continuous Cyclic Peritoneal Dialysis (CCPD)

Continuous Cyclic Peritoneal dialysis is a form of automated peritoneal dialysis.Cyclers with timers that allow dwell times of several hours is necessary.CCPD users must carry out 3-5 nightly exchanges over 10-12 hours, plus a daytime exchange remain in the peritoneal cavity to control uremia. It avoid  interrupting daytime activities and may also reduce the incidence of PD complications.

Tidal Peritoneal Dialysis (TPD)

Tidal peritoneal dialysis is a therapy in which the patient abdomen is filled with dialysate, and a portion of the dialysate is drained and replaced by fresh dialysate.Theis leaves a residual volume always in contact with peritoneal membrane while partial exchanges are carried out throughout the night. It is one form of automated peritoneal dialysis which permits a reduction in dialysis time and improves the efficiency of dialysis by keeping the abdomen full while drain and fill times.