For most people with mild CKD (stages 1-3) treatment will consist of adopting a healthy lifestyle and taking some medications to control their blood pressure and prevent their kidneys from getting worse.
If your CKD progresses to stage 4-5 you will need to start thinking about the treatment options available for kidney failure.
Read our guide to living with early stage chronic kidney disease (PDF 4Mb)
Choosing the treatment option that's right for you
The flow of fluids in the peritoneal dialysis process.
Peritoneal dialysis is a process that removes the waste products from your blood by using the peritoneal membrane in your abdomen as a natural filter.
How does it work?
A small, soft, plastic tube, called a catheter, is inserted into your abdomen. This allows dialysis fluid to be drained in and out of the peritoneal cavity.
Waste products are passed from your blood, across your peritoneal membrane, and absorbed into the dialysis fluid. When the fluid is drained out again it takes waste and extra fluid out of your body.
Dialysis is happening all the time because there is fluid in your abdomen until the next 'exchange'. The fluid needs to be changed regularly. This can be done either by hand four times a day and is known as CAPD or by a machine overnight, known as APD.
Are there different types of PD?
There are two types of PD:
Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD).
Learning how to do PD takes as long as you need. This is usually about five days. It can be done:
at the hospital.
in your own home.
at a training centre.
Is any surgery involved?
Yes, you will need a small operation to put the catheter into your abdomen. Many people stay in hospital overnight, but you might be able to go home the same day.
Does PD hurt?
It might seem uncomfortable at first as you get used to having fluid in your peritoneal cavity. The fluid is warmed to body temperature so you should not feel it going into your body.
Can I go swimming?
Yes, swimming is a good form of exercise. However, it is better that you swim in a chlorinated pool as the sea and rivers can be contaminated.
Can I have a bath?
To reduce the risk of infection, it is better to shower rather than bath once you start PD.
Why PD may be right for you
Why PD may not be right for you
You do not have to come into hospital to do your dialysis. You will only need to come to the clinic for check ups.
You should be able to fit dialysis in around family, social and work life.
It is similar to the way your kidneys work because it is happening all the time. This means that what you eat and drink is not as restricted as with haemodialysis.
Supplies can be delivered to most places.
It is fine to exercise while on PD. However, we advise against any heavy lifting or contact sports.
If you choose APD you dialyse overnight instead of during the day, making it easier to fit around work and leisure.
- PD needs to be done every day. You need to be able to build this into your life.
- You will need a clean, dry area to store supplies, which take up about the same space as a single bed. This could be a spare room, a large cupboard, a shed or a garage.
- PD may not be suitable for you if you:
- have had major surgery on your abdomen.
- have bowel disease such as diverticulitis, colitis or are very overweight.
- live alone and need significant support.
- do not have a permanent address.
- If you choose CAPD you will need to be flexible in your daytime activities so that you have time to do four exchanges.
What are the possible complications with PD?
The main complication is peritonitis, which is an infection of the peritoneal membrane, the lining of the peritoneal cavity where the fluid sits. You will be shown how to reduce the risk of peritonitis and what to do if you think you have it.
Occasionally you might get an infection where the catheter comes out of your abdomen, known as the exit site. This can usually be treated successfully with antibiotics.
Sometimes people have problems draining the fluid out of their body, but you can be taught how to deal with this.
In a small number of cases an abdominal hernia might happen because of pressure caused by the dialysis fluid. If this happens you will need a small operation to repair the hernia.