Peritoneal Dialysis: At Home Treatment for Kidney Failure | Mass General Brigham

Summary

Dr. John Kevin Tucker, a kidney specialist, discusses the importance of dialysis for patients with chronic kidney disease, particularly focusing on peritoneal dialysis. He explains how it works, highlighting the two main types: Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cycling Peritoneal Dialysis (CCPD). Peritoneal dialysis allows patients to manage treatment at home, offering flexibility and independence. Dr. Tucker also dispels common myths, such as age being a barrier and the necessity for advanced education, emphasizing the support patients receive from a multidisciplinary team. He reassures that with proper training, patients can successfully perform dialysis on their own.

Takeaways

• 😀 More than 450,000 individuals in the U.S. require renal replacement therapy or dialysis due to kidney failure.
• 😀 Kidney transplantation is the optimal form of renal replacement, but due to a shortage of kidneys, many patients rely on dialysis.
• 😀 There are two main types of dialysis: hemodialysis (blood-based) and peritoneal dialysis (not blood-based).
• 😀 Peritoneal dialysis is often preferred for home use, offering greater flexibility for patients compared to in-center hemodialysis.
• 😀 Peritoneal dialysis uses the peritoneum (abdominal lining) as a filter to remove toxins from the body.
• 😀 There are two forms of peritoneal dialysis: Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cycling Peritoneal Dialysis (CCPD).
• 😀 In CAPD, patients manually exchange dialysis fluid several times a day, while CCPD uses a machine for overnight exchanges.
• 😀 Age is not a barrier for peritoneal dialysis. Many elderly patients choose this option due to its convenience over in-center hemodialysis.
• 😀 Peritoneal dialysis can be successfully performed by individuals with varying educational backgrounds, including those with low literacy.
• 😀 Patients are trained by specialized nurses to perform peritoneal dialysis at home, with training typically lasting one to two weeks.
• 😀 A home visit by a dialysis nurse is required to ensure the home environment is suitable for performing peritoneal dialysis safely.

Q & A

What is the main topic of the video?

The video discusses dialysis options, specifically focusing on peritoneal dialysis, as a treatment for individuals with chronic kidney disease.

How many individuals in the United States require renal replacement therapy or dialysis?

More than 450,000 individuals in the United States require renal replacement therapy or dialysis.

What are some common signs and symptoms of kidney failure?

Some common signs and symptoms of kidney failure include nausea, loss of appetite, fatigue, mental cloudiness, and itching.

What is the most optimal form of renal replacement therapy?

Kidney transplantation is the most optimal form of renal replacement therapy, but there are not enough kidneys available for everyone.

What are the two major forms of dialysis?

The two major forms of dialysis are hemodialysis, which involves the blood, and peritoneal dialysis, which does not involve blood.

What factors influence a patient's choice between hemodialysis and peritoneal dialysis?

The choice between hemodialysis and peritoneal dialysis often depends on personal choice, lifestyle, and life situation, such as employment or school changes.

What is peritoneal dialysis, and how does it work?

Peritoneal dialysis uses the peritoneum, a lining around the organs in the abdomen, as a filter. A solution is placed into the abdomen, and poisons normally filtered by the kidneys are removed through this lining.

What are the two forms of peritoneal dialysis?

The two forms of peritoneal dialysis are continuous ambulatory peritoneal dialysis (CAPD), which involves manual exchanges, and continuous cycling peritoneal dialysis (CCPD), also called automated peritoneal dialysis, which uses a machine.

How does continuous ambulatory peritoneal dialysis (CAPD) work?

In CAPD, the patient manually exchanges dialysis solution three or four times a day. The process involves draining the old solution and installing fresh solution, which takes about an hour.

How does continuous cycling peritoneal dialysis (CCPD) work?

In CCPD, a machine performs several cycles or exchanges overnight, typically for 8 to 9 hours. The patient connects to the machine before bedtime and disconnects in the morning, with minimal effort required during the day.

What are some common myths about peritoneal dialysis?

Two common myths are that age is a contraindication to home peritoneal dialysis and that education is required to perform it. In reality, age is not a barrier, and patients can be trained regardless of their educational background.

What is the training process for patients starting peritoneal dialysis?

Patients undergo training to learn how to perform peritoneal dialysis, which typically takes 1 to 2 weeks. The training is provided by an experienced dialysis nurse, and a home visit is required to ensure the home environment is safe.