The most common types of PD are continuous cycler-assisted peritoneal dialysis (CCPD) and continuous ambulatory peritoneal dialysis (CAPD). CCPD uses a machine called a cycler to do exchanges.
CAPD uses gravity to help you do the exchanges by hand. Both types of PD can be done at home, by yourself, and CAPD can be done anywhere that is clean and dry. Depending on what fits best with your lifestyle and schedule, you may choose to do one or the other, or your doctor might recommend that you do both.
No matter which type of PD you choose, your doctor will ask you to have some tests during the first few weeks of your treatment. These tests are used to help your doctor figure out if you are getting the right amount of dialysis. Based on your test results, your doctor might tell you to change how often you do exchanges, the type of dialysate you use or the amount of dialysate you use.
Continuous cycler-assisted peritoneal dialysis (CCPD)
CCPD is usually done at night, while you sleep. You will connect your catheter to tubes going to a machine called a cycler. This machine does your exchanges for you. It will fill your abdomen with dialysate, wait for the correct dwell time, and then drain the used dialysate from your abdomen into a bag. The machine will refill your abdomen with clean dialysate and begin the process again.
In most cases, the cycler will do three to five exchanges overnight. This usually takes about nine hours. Every morning, the machine will fill your abdomen with dialysate for the last time. This time, the dialysate will sit in your abdomen for the whole day, until you go to bed and begin your nightly CCPD treatment again.
Your doctor will tell you how many exchanges you should do and how long your dwell times should be. Your dialysis nurse or technician will show you how to set up the cycler machine to give you the right treatment.
During the long daytime dwell time, some people have problems with their bodies holding on to too much of the dialysate. If this is a problem for you, your doctor may tell you to do one exchange during the day. Your doctor might also ask you to do some daytime exchanges if you weigh over 175 pounds or if you need to have more waste removed from your blood than what can be done during your CCPD treatments overnight.
Continuous ambulatory peritoneal dialysis (CAPD)
CAPD exchanges are done by hand, using gravity to help fill your abdomen with dialysate and drain it once the dwell time is over. These exchanges are called manual exchanges. Because you need to do each exchange yourself, this type of PD must be done during the day. You may do your exchanges anywhere that is clean and dry.
To fill your abdomen with dialysate, you will sit in a chair, with a tube attached to a bag of dialysate that is hanging above you. Gravity will pull the dialysate down from the bag, through the tube into your abdomen. To drain the used dialysate, you will attach a tube to your catheter, and let gravity pull the dialysate out of your abdomen, through the tube and into a bag below you. It usually takes between 30 and 40 minutes to drain and refill your abdomen with dialysate.
Between exchanges, you will let the dialysate sit in your abdomen for the dwell time. At the end of each day, you will fill your abdomen one last time, and the dialysate will sit in your abdomen all night long. In the morning, you will begin doing normal exchanges again. Your doctor will tell you how many exchanges you should do each day and how long your dwell times should be.
During the long nighttime dwell time, some people have problems with their bodies holding on to too much of the dialysate. If this is a problem for you, your doctor may tell you to use a minicycler to do some exchanges at night, while you sleep. A minicycler is a small version of the cycler machine that is used for CCPD. Your doctor might also ask you to use the minicycler at night if you weigh over 175 pounds or if you need to have more waste removed from your blood than what can be done during your CAPD treatments during the day.