Peritoneal dialysis (PD)

About peritoneal dialysis: what’s involved, different types of PD, how it works, benefits and drawbacks, and sources of further information and support

What is peritoneal dialysis?

Peritoneal dialysis is a treatment for kidney failure. When your kidneys don’t work properly, they can’t clean your blood, so toxins build up in your bloodstream. Your kidneys also make less urine, so excess fluid and waste products remain in the body.

Peritoneal dialysis uses the inside lining of your abdomen (the peritoneum) to filter your blood, within your body. This filtering removes waste products that have built up in your blood stream.

A special fluid called dialysate, which contains water, salts and other additives, flows from a bag into your abdomen through a soft tube called a catheter. The catheter stays in your abdomen all the time, with part of the catheter on the outside of your body. It is soft to touch and should feel comfortable.

While it is inside you, the dialysate absorbs waste products and extra water from your body. The dialysate is then drained out of your body, taking the toxins and excess water with it. This process is called an exchange.

How can peritoneal dialysis help me?

Peritoneal dialysis can help relieve symptoms related to kidney failure, including feeling sick, tired or weak.

It can also help with symptoms caused by having too much fluid in your body, such as puffy ankles and shortness of breath.

Peritoneal dialysis can also help to protect your bones and reduce your potassium levels. Unlike haemodialysis (HD), which you will usually have in hospital, peritoneal dialysis is performed at home, offering you greater flexibility and independence.

How often will I need to have peritoneal dialysis?

Most people have peritoneal dialysis every day. Your healthcare team will discuss the right treatment schedule for you.

Will peritoneal dialysis repair my kidneys?

If you have chronic kidney disease (CKD), the damage to your kidneys cannot be fully repaired.

Dialysis does the job of healthy kidneys by removing toxins and fluids from your body, but it will not cure your CKD. Once you start dialysis you will need to continue with it for the rest of your life, or until you receive a kidney transplant.

Are there different types of peritoneal dialysis?

There are two types of peritoneal dialysis, depending on whether you want to dialyse during the day or at night. This may depend on your lifestyle, your medical history and your kidney function.

Your kidney team will discuss the different treatment options with you. Whichever one you choose, it is important to perform all your exchanges as recommended by your kidney team.

Continuous ambulatory peritoneal dialysis (CAPD)

CAPD involves performing between one and four exchanges during the day. You may be prescribed one exchange a day at first and then increase the number of exchanges if your kidney function continues to decline.

During each exchange, your catheter will be connected to a bag of dialysate, which is hung on a hook by your chair. The dialysate takes around 30 to 40 minutes to flow into your body.

Once your abdomen is full of fluid, you disconnect from the bag and place a cap on your catheter. As you are doing your usual daily activities, the solution inside your abdomen will absorb waste and extra fluid from your body.

After a few hours, the fluid is drained out of your abdomen into an empty bag, which is then thrown away. The process is then repeated with a new bag of dialysate.

Automated peritoneal dialysis (APD)

APD is done overnight while you sleep, using a machine about the size of a small suitcase. The dialysate flows into your abdomen through your catheter and is taken out automatically by the machine. This happens between three and five times a night.

What needs to happen before I can start dialysis?

You will need to have a small operation to insert the catheter into your abdomen.

This may be under a local anaesthetic, or you may need a general anaesthetic, especially if you have had operations on your abdomen before. After the operation, you will usually need to wait two weeks to recover before you can start peritoneal dialysis.

How will peritoneal dialysis affect my life?

Peritoneal dialysis allows you greater flexibility and control over your treatment than hospital-based haemodialysis.

You will still need to make some changes to fit your dialysis treatment into your daily routine. If you do exchanges during the day, you will need to stop your normal activities for about 30 minutes each time to perform an exchange.

You will need a cool, clean and dry space in your home to store your dialysis supplies, about the size of a double wardrobe. You will also need a clean, dry and well-lit space to perform your exchanges, with easy access to a sink to wash your hands.

If you do automated peritoneal dialysis, you will need to set up the dialysis machine every night before you go to bed. You will need to take laxatives as it is important that you open your bowels twice a day and that your poo is soft. This will help your dialysis to work effectively.

You may also need to take vitamin tablets as peritoneal dialysis can remove certain vitamins from the body. You might also be given a water tablet to help your kidneys continue to produce urine.

Your kidney team will check whether you need to continue to take any other medications for your kidney disease while you are on peritoneal dialysis.

Will I receive any other medication?

You will need to take laxatives as it is important that you open your bowels twice a day and that your poo is soft. This will help your dialysis to work effectively.

You may also need to take vitamin tablets as peritoneal dialysis can remove certain vitamins from the body. You might also be given a water tablet to help your kidneys continue to produce urine.

Your kidney team will check whether you need to continue to take any other medications for your kidney disease while you are on peritoneal dialysis.

Who will help me with my treatment?

Most people who have peritoneal dialysis carry out the treatment themselves.

A dialysis nurse or healthcare assistant will teach you how to dialyse at home and how to avoid infections. Some kidney units offer assisted peritoneal dialysis where a healthcare worker or carer helps you carry out some of the treatment tasks. You will be given all the equipment you need and will receive monthly deliveries of dialysate to your home.

What other health professionals will be involved?

A kidney dietitian will check whether you need to make any changes to your diet, such as limiting the amount of salt, potassium or phosphate that you eat.

They will help with practical suggestions about how to adapt your diet. They will also check to see if you need any supplements to add extra vitamins and minerals to your diet.

Your kidney team will check your blood test results regularly to make sure that your treatment is as effective as possible. Your dialysis schedule may be adjusted depending on these results and on your weight, blood pressure and how well you are coping with treatment.

What support is available to help me?

Starting peritoneal dialysis is a big change. It will impact your everyday life and routines, including work, social life and relationships.

Peritoneal dialysis can give you a sense of control over your treatment and allow you a greater amount of flexibility than having to go to hospital to receive your dialysis.

Your kidney team are there to help you and your family. You may also find it useful to talk to a renal social worker, counsellor or patient organisation such as Kidney Care UK. They can all help you with a range of practical, emotional and financial matters.

Will I still be able to travel?

Yes – you can still go on holiday if you are on peritoneal dialysis.

It is important to plan your travel in advance with your dialysis team – ideally give at least three months’ notice. If you are away from home, you will need to arrange for dialysis supplies to be delivered to your accommodation.

For more information read the Dialysis Away From Base (DAFB) information or talk to your kidney team.

What are the side effects of peritoneal dialysis?

Peritoneal dialysis can leave you feeling tired, sick and washed out. These symptoms can be eased by reducing the amount of fluid that needs to be removed at each dialysis session.

This depends on how much you drink between each session. Your kidney team can advise you on how to measure and control your fluid intake. This is known as fluid restriction.

You may develop an infection where the catheter enters your abdomen, or within the abdomen itself. Your kidney team will explain what symptoms to look out for and how to report them. Infections can be treated with antibiotics.

Peritoneal dialysis increases the chances of developing a hernia, which is a weakness in your abdominal wall. Hernias can occur by your belly button, near the catheter exit site or in your groin. Tell your kidney team if you notice a new lump or swelling.

Your medical team will discuss all possible risks with you before you start PD and will check on you regularly to make sure you are staying healthy.

How can I stay healthy on dialysis?

Keep fit

Try to exercise at least two or three times a week. Kidney disease makes your muscles weak, so it is important to keep moving to keep them strong. Your kidney team may refer you to a physiotherapist who can help design the right exercise routine for you.

Perform every dialysis session

It is very important that you perform all of your dialysis sessions as instructed by your kidney team, so that the toxins are regularly removed from your blood stream.

Check your medications

Some medicines can be harmful to people with kidney disease. Tell your kidney team about any medicines that you are taking, even if they are not related to your kidney disease. This includes medicines, herbal remedies or supplements that you buy yourself from a chemist or health food shop.

Check your blood pressure regularly

Your kidney team can teach you how to do this yourself at home.

Keep to your diet and fluid allowances

Your dietitian will give you personalised advice about any fluid restrictions and any changes that you need to make to the food you eat.

Other ways you can stay as healthy as possible on dialysis include:

  • Stop smoking (if you are a smoker)
  • Try to maintain a healthy weight
  • Give up or cut down your alcohol intake.

Are there any alternatives to peritoneal dialysis?

Other treatments for kidney failure include:

  • Haemodialysis, which usually takes place in hospital and uses a dialysis machine filter to clean your blood.
  • A kidney transplant from a donor.
  • Managing the symptoms of kidney disease without active treatment (conservative care).

Your kidney team will discuss these choices with you and your family so you can decide which is the best option.

Where can I find out more information?

Peritoneal Dialysis: download or order Kidney Care UK's information leaflet

You can download our Peritoneal Dialysis leaflet for free.

You can also order a printed copy of Kidney Care UK’s Peritoneal Dialysis leaflet to be sent to you in the post.

Publication date: 09/2023

Review date: 09/2026

This resource was produced according to PIF TICK standards. PIF TICK is the UK’s only assessed quality mark for print and online health and care information. Kidney Care UK is PIF TICK accredited.