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CAPD – Continuous Ambulatory Peritoneal Dialysis

What is peritoneum?
Peritoneum is a thin, semipermeable membrane that keeps the stomach, intestines, liver and other organs in place.

How many methods of peritoneal dialysis are there?

  • CAPD: Continuous Ambulatory
  • Peritoneal Dialysis
  • APD: Automated Peritoneal Dialysis

What do you need to perform peritoneal dialysis?
CAPD Catheter, associated connection apparatus, Dialysis solution & Drain bag

What is peritoneal dialysis catheter?
The catheter for peritoneal dialysis is a small plastic (silicon) tube that is introduced into the peritoneal cavity by means of simple operation.

What is the function of peritoneal dialysis catheter?
The catheter is used to drain PD solution in and out of peritoneum.

How are wastes and excess water eliminated during peritoneal dialysis?
The dialysis solution is infused into the peritoneum and when blood passes through the peritoneum, exchange takes place & then it is drained out.

When will CAPD cycles be started?
CAPD cycles are started after two weeks after insertion of CAPD catheter

What care must be provided immediately after insertion of catheter?
Ensure that the exit site and surgical wound dry. They should not get wet for atleast 10 days after placement.

What is the long term care of the catheter and the exit site?
Daily bathing and cleaning of the exit wound Immobilization of the catheter

What does the dialysis exchange involve?
An exchange consist of 3 steps

Drain: means removing the solution from the peritoneal cavity by gravity; this process takes approximately 20 minutes

Infuse: means introducing dialysis solution into the peritoneal cavity through a catheter for less than 10 minutes.

Dwell time: period in which the dialysis solution remains inside peritoneal cavity for an average duration of 4 to 6 hours. Exchange is generally repeated every 4-6 hours.

Where we can perform CAPD?
You can perform the exchange in your home, at your work place; but these areas must be clean.

What are the guidelines for eating a healthy diet while you are under peritoneal dialysis?
Food you should eat MORE of:

  • Protein
  • Fiber
  • Food you should eat less of:
  • Avoid eating foods rich in phosphorus, potassium and sodium
  • Watch your intake of salt and fluids
  • Limit the quantity of sugars and fats.

Are there any complications with CAPD?
Yes. Infection (peritonitis) can set in if there is a break in the aseptic technique of performing the exchanges. Other complications like weight gain, increase in blood sugars, triglycerides can occur. Certain patients can have catheter migration & have drainage problems.

Who are the candidates for CAPD?
Anyone with end stage renal disease is eligible to undergo CAPD. Some patients choose it for convenience. Some patients need it as they have vascular access problem & cannot undergo HD. Some of them are recommended CAPD as their cardiac status is poor & prone for complications on HD.

Are there any contraindications for CAPD?

Yes. Patients who have a congenital defect in the diaphragm cannot undergo CAPD as the fluid instilled into the abdomen will fill the pleural cavity. Patients with active intraabdominal infection or patients who have undergone major intraabdominal surgeries may not be fit candidates for CAPD.

Is CAPD as effective as haemodialysis?
Yes. But CAPD has to be performed atleast three exchanges a day to achieve the efficacy of haemodialysis which is recommended thrice weekly.

What is automated peritoneal dialysis?
Automated peritoneal dialysis is one where the exchanges are performed usually at night with the help of a machine .Patient is hooked onto the machine at night when he goes to sleep & the exchanges are completed by the time he is awake the next day.

Is training required to perform CAPD?
Yes. Patient or if he is unable to do it himself, his close relatives have to be trained to perform CAPD .Patient is usually hospitalized two weeks after the insertion of the catheter. CAPD coordinator trains the patient/relative at the hospital for about a week. Patient is discharged once the coordinator is convinced that the person is capable of performing CAPD on his/her own.

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