Peritoneal dialysis for Diabetes

Overview
Type 2 diabetes damages the kidneys, sometimes to the point where they can no longer function well enough to keep you healthy. People with severe kidney damage require kidney replacement therapy. Peritoneal dialysis is one type of kidney replacement therapy. Other types include hemodialysis and kidney transplants.

What does it involve?
In peritoneal dialysis, the peritoneum, or tissue lining your abdomen, is used to filter waste products from the blood. Before you begin receiving peritoneal dialysis, you will receive minor surgery to place a soft tube in your abdomen.

There are two main types of peritoneal dialysis: continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) or automated peritoneal dialysis (APD).

In CAPD, you will perform dialysis by attaching a plastic bag to the tube and emptying approximately two quarts of sterile cleansing fluid (dialysate) into your belly by raising the bag up to your shoulders. Later, you will drain the dialysate (now containing waste products from your blood) from your belly into another bag. Each cycle (known as an exchange) of dialysis takes 30 to 45 minutes, and you will perform three to five exchanges each day during waking hours. You can perform CAPD as you go about your normal daytime activities.

In CCPD/APD, you will connect a machine (called a cycler) to the tube in your abdomen when you go to sleep. The machine will pump in the dialysate and drain it automatically overnight.

One advantage of peritoneal dialysis is that your body does not build up as much fluid and waste as it does with hemodialysis. Stress on your heart and arteries is reduced. It is also easier to maintain a normal work schedule with peritoneal dialysis.

Constraints
Your health insurance program may not pay for 100 percent of your peritoneal dialysis costs.

If you are morbidly obese or have had multiple abdominal surgeries, your belly may not be appropriate for peritoneal dialysis.

You must have good vision to perform peritoneal dialysis correctly and prevent infection.

Peritonitis, an infection of the peritoneum, is a rare but serious complication of peritoneal dialysis.

After some time on either hemodialysis or peritoneal dialysis, you may develop nutritional deficiencies, anemia, and bone problems.