Continuous Ambulatory Peritoneal Dialysis

WHAT YOU SHOULD KNOW:

• Continuous ambulatory peritoneal dialysis (CAPD) is done to remove wastes, chemicals, and extra fluid from your body. The peritoneum is a thin lining on the inside of your abdomen (stomach), and some other organs. During CAPD, a liquid called dialysate is put into your abdomen. It is put in through a CAPD catheter. The catheter is a tube that goes from the outside, to the inside of your abdomen. The dialysate pulls wastes and substances from your blood and lymph fluid through the peritoneum. The wastes mix with the dialysate. The peritoneum works like a filter as the wastes are pulled through it.
  
  
• The dialysate is left in your abdomen for 3 to 5 hours. This is called the dwell time. After the dwell time, the dialysate is drained out through the catheter. Filling and emptying your abdomen with dialysate is called an exchange. Exchanges may be done 3 to 5 times during the day, and once during the night. CAPD exchanges can decrease or take away problems such as swelling, itching, fatigue, and weakness. CAPD can help decrease high blood pressure, and make you feel more like doing the things you enjoy.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

• During catheter insertion, you may bleed more than expected and lose a lot of blood. Your wound may not heal well and your catheter may not work as it should. You may need to have it removed or replaced. During CAPD, you may feel pain in your back and stomach. You may lose your appetite, lose weight, and feel weak. You may have high sugar and cholesterol levels in your blood. Having the CAPD catheter increases your risk of getting an infection on your skin or in your abdomen.
  
  
• If you do not have a CAPD catheter put in, you will not be able to do CAPD exchanges. If you do not have these exchanges, symptoms from kidney problems will get worse and stay longer. Wastes, chemicals, and extra water will build up in your body. You will feel very tired and weak. You may be confused, and lose your memory. Your arms, legs, and face will swell up. Your blood pressure may increase higher, and you may have trouble breathing. You may lose consciousness (go into a coma) and even die.

WHILE YOU ARE HERE:

Before your procedure:

• Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• Antibiotics: Antibiotics are given to help prevent infection during and after your procedure.
  
  
• Anesthesia: Anesthesia is medicine to make you comfortable during surgery. Caregivers work with you to decide which anesthesia is best and whether you will be awake or completely asleep. Do not make important decisions for 24 hours after having anesthesia. Also, do not drive or use heavy equipment. An adult may need to drive you home and stay with you after you have had anesthesia.
  
  
• Monitoring:
  
  
  • Heart monitor: This is also called an ECG. Sticky pads are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen. This shows caregivers a tracing of the electrical activity of your heart.
    
    
  • Pulse oximeter: A pulse oximeter is a machine that tells how much oxygen is in your blood. A cord with a clip or sticky strip is placed on your ear, finger, or toe. The other end of the cord is hooked to a machine. Caregivers use this machine to see if you need more oxygen.

During your procedure:

• Your caregiver makes a cut below or beside your belly button, or just below your ribs. Your caregiver cuts through muscles and tissues to make a hole for the catheter. He may use a peritoneoscope to help him see inside your abdomen while he inserts the catheter. When the catheter is in the right place, liquid will be put in through it. Blood thinning medicine may be put through the catheter to prevent the catheter from getting blocked. The catheter is held in place with stitches, and the area is covered with bandages.
  
  
• Instead of putting the catheter in place right away, it may be placed just below your skin for 3 to 5 weeks. This lets the area heal, and may help prevent infection. Later, the catheter will be ready to be used for your dialysis exchanges.

After your procedure: You may be taken to a room where you will stay until you wake up and caregivers see that you are okay. Do not try to get out of bed until your caregiver says it is OK. You may then be taken to a hospital room, or you may be able to go home. The bandages covering the area will help keep it clean and dry. A caregiver will check the catheter exit site and the area around it, and change your bandage. Your caregiver will teach you and your family how to do CAPD. You will learn how to set up and use your dialysis supplies and equipment. You will also learn what to do if you have problems during a dialysis exchange.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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