Peritoneal dialysis (PD) is a method of cleaning the blood without the blood leaving the body by using your peritoneal membrane, which consists of two layers, which lines the inside of your abdomen. Dialysis fluid is introduced into the space between these layers.
In order to do introduce the fluid, a soft plastic tube called a Tenckhoff catheter is inserted into the abdomen. Once in place the tube is permanent and should last for many years. It can be changed if necessary or removed if it is no longer required, for example, if you have a kidney transplant.
We aim to plan and prepare access for PD before the time for dialysis arrives, so that when it does everything is that much more straightforward.
You will be assessed by a PD specialist and a decision made as to whether you can have the procedure under local anaesthetic or under general anaesthetic. If a local anaesthetic is required, the PD doctor will arrange a date for you to come to the day surgery unit and it will be inserted as a day case. If you require general anaesthetic, you will be referred to a renal surgeon who will normally see you in outpatients and arrange a date for your operation.
You will need to arrange for 4 weeks off work after the operation
You will not be able to drive after the operation, so please make appropriate arrangements for getting to and from the hospital.
It is important that you are not constipated when the catheter is inserted. Therefore, you will be given a laxative to take a few days before the operation.
If you are having the operation done as a day patient, going home at the end of the day, it is advisable to have someone stay with you at home overnight.
If you are having a local anaesthetic, you may have a light meal e.g. tea an toast before coming into hospital. If you are having a general anaesthetic you will not be permitted to eat and drink for about 6 hours before you have the procedure.
Before you can have any operation you must give your consent. In order to obtain consent the doctor will explain the procedure, what it is for, what happens and the risks and benefits of having it done and answer any questions that you or your family may have about the test before you sign the consent form.
You will be admitted to the hospital for a day and possibly an overnight stay. If you need dialysis, this stay may be lengthened.
Initially the area will be well padded and the dressing left undisturbed for the first five days. Usually there are no sutures to remove.
You may experience some discomfort for the first couple of days, but the pain should be relieved with pain killing tablets Carry on your normal life-style as you are able. However, straining on your stomach muscles, which may be caused by lifting heavy objects and sex is best avoided for the first 4 to 6 weeks.
You are advised to take 4 to 6 weeks off work and avoid driving for the first two weeks or until you are able to make an emergency stop comfortably.
Avoid wearing tight or restrictive clothing and belts that may cause friction over the dressing.
The CAPD nurse will see you and discuss the above points with you before you are discharged. You will also be given dates to attend the CAPD unit during the next 10 days for the changing of your dressing and the taking of blood samples
At the final visit, you will be either taught to change the dressing yourself or we will arrange for a district nurse to call. You will be supplied with the necessary equipment.
After the tenth day, if you do not need to start dialysis, you will continue to attend the outpatients department until there is further deterioration in your kidney function. At this stage, you will be informed of a date to start your training.