Peritoneal Dialysis

What is Peritoneal Dialysis?

One of the key benefits of Peritoneal Dialysis (PD) is that it can be carried out at home. It is needle-free, less expensive than “regular” dialysis (known as haemodialysis, which uses a dialysis machine to clean the blood) and may offer some flexibility within a daily schedule.

For the patient it offers better protection of the remaining kidney function and less fluctuation in blood pressure.

How Does it Work?

A small, soft tube (called a PD catheter) will be permanently placed in the patient’s peritoneal cavity through a small incision in the abdomen.

During dialysis, which is usually required daily, dialysis fluid called dialysate will be placed and removed via this catheter at regular intervals. This allows for the removal of toxins and extra water through the patient’s peritoneal cavity. 

Patients who have had multiple abdominal surgeries may not be suitable for PD.

There are two forms of PD treatments: Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD). 

Continuous Ambulatory Peritoneal Dialysis (CAPD)

CAPD is a treatment process which makes use of gravity to fill and empty the fluid in the patient’s abdomen. PD exchanges are typically done on waking, at lunch, at dinner and prior to sleeping.

In CAPD, the exchange of the dialysate is carried out manually by the patient or a caregiver during the day. At each exchange, patients may take up to 30 minutes to remove the spent dialysate from the abdomen and place a fresh bag of clean dialysate. After this, patients are free to continue their usual activities until their next exchange is due.

Automated Peritoneal Dialysis (APD)

APD is an alternative to CAPD which requires a small machine to deliver dialysis fluid into the abdomen every night while the patient is asleep.

In APD, a machine is attached to the patient’s PD catheter at night. This delivers the clean dialysate and drains spent dialysate while the patient is sleeping. In the morning, patients can then disconnect from the machine and carry on with their daily activities.

For both procedures a short hospital stay (e.g. day surgery) is required to insert a PD catheter into the abdomen.

Home Dialysis Costs

CAPD costs S$1,100 to S$1,300 per month. APD costs S$1,600 to S$1,800 per month (excluding electricity bill).

This article is jointly developed by National Healthcare Group, National University Health System, SingHealth and Ministry of Health

Related links 

Kidney Health
Kidney Stones
Chronic Kidney Disease

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