APPLICATION 2: PERITONEAL DIALYSIS Health kidneys clean our blood by removing excess fluid, minerals and wastes.

They also make hormones that keep our bones strong and our blood healthy. When our kidneys fail, harmful wastes build up in our body. Our blood pressure may rise, and our body may retain excess fluid and not make enough red blood cells. When this happens, we need treatment to replace the work of our failed kidneys. Peritoneal

dialysis is another procedure other than hemodialysis to removes extra water, wastes, and chemicals from our body. The main concept of kidney that I want to focus here is osmoregulation and this concept is same as hemodialysis. The difference between hemodialysis and peritoneal dialysis are how they remove excess fluid, minerals and wastes from our blood. This type of dialysis uses the lining of our abdomen to filter our blood. This lining is called the peritoneal membrane and acts as the artificial kidney.

Figure 3: Continuous Ambulatory Peritoneal Dialysis(CAPD) (Source: Bethesda, 2006) In peritoneal dialysis, a soft tube called a catheter is used to fill our abdomen with a cleansing liquid called dialysis solution. The walls of our abdominal cavity are lined with a membrane called the peritoneum, which allows waste products and extra fluid to pass from our blood into the dialysis solution. The solution contains a sugar called dextrose that will pull wastes and extra fluid into the abdominal cavity. These wastes and fluid then leave our body when the dialysis solution is drained. The used solution, containing

wastes and extra fluid, is then thrown away. The period the dialysis solution is in our abdomen is called the dwell time. A typical schedule calls for four exchanges a day, each with a dwell time of 4 to 6 hours. Different types of peritoneal dialysis have different schedules of daily exchanges.

Figure 4: Continuous Cycler-assisted Peritoneal Dialysis (CCPD) (Source: Bethesda, 2006) There are two types of peritoneal dialysis that are continuous ambulatory peritoneal dialysis (CAPD) and continuous cycler-assisted peritoneal dialysis (CCPD). CAPD

does not require a machine. As the word ambulatory suggest, we can walk around the dialysis solution in our abdomen. Another form of peritoneal dialysis, CCPD, requires a machine called a cycler to fill and drain our abdomen, usually while we sleep. The most common problem with peritoneal dialysis is peritonitis, a serious abdominal infection. To avoid peritonitis, we must be careful to follow procedures and learn to recognize the early signs of peritonitis. Report this sign to our doctor

immediately so that peritonitis can be treated quickly to avoid serious problems.