What is it?
Our kidneys usually filter and remove waste products and excess fluid from the blood. Continuous ambulatory peritoneal dialysis (CAPD) is a way of replacing your kidney function, if your kidneys have failed, by using the membrane covering your internal organs (the peritoneum).
The peritoneum is a natural filter, with a rich supply of tiny blood vessels (capillaries), which lines a space in your body called the peritoneal (or abdominal) cavity. During peritoneal dialysis between one to three litres of fluid is put into the space through a catheter (a permanent soft, flexible plastic tube) attached to your abdomen. The fluid (known as dialysate) then sits there for several hours whilst waste products pass from the capillaries into the liquid. It is then drained out into an empty bag and thrown away.
The process of adding fresh liquid and draining out used liquid is called a dialysis ‘session’ or ‘exchange’. It is usually performed four times a day, every day, and each session takes about 40 minutes.
Watch this animation, from the Kidney Patient Guide, to see how peritoneal dialysis works.
How do I get a catheter?
A specialist will put the catheter in your abdomen, just below your belly button. The procedure will be done under local or general anaesthetic and you may be required to stay in hospital for 24-48 hours afterwards.
About a week to ten days later, a nurse will take out your stitches and you should be able to start CAPD shortly afterwards.
Can I do CAPD myself?
Yes. Your kidney team, GP and District Nurse will work together to help you. You will be:
- Supported by a dialysis nurse who will work closely with you. They will teach you how to perform the exchange procedure, take care of your catheter and exit site and cope with any problems. They will also give you advice about when and where you should do your CAPD (including helping you make arrangements to do it in a clean place at home, at work and on holiday too). They can also help you if you have any worries about how you will cope with your CAPD.
- Given equipment, including bags and a hook to hang your fluid bag during an exchange, together with advice on where to store things. You will also be shown how to re-order supplies and arrange deliveries to your home or holiday destination.
A family member, friend or nursing assistant can also be trained to help you with your CAPD and your kidney doctors will give you regular check-ups to see how you and your kidneys are doing.
Will I need a special diet and medications?
Your kidney dietitian will help you to maintain a healthy, balanced diet (link to diet page in ‘how can I help myself?’ section). You may be required to restrict certain foods (for example those containing potassium, phosphates and high levels of salt) but you should only restrict your diet if your kidney dietitian has advised you to do so.
Your kidney doctor may prescribe:
What are the benefits of having my dialysis at home?
Many people like the independence it brings. You don’t need to travel to hospital or a dialysis unit for your treatment – you can do it yourself in the comfort of your own home, at work and while on holiday too.
Are there any potential problems?
The most common potential complication of CAPD is infection – of the exit site or of the peritoneum (peritonitis).
But your dialysis nurse will work closely with you to help you avoid infection by showing you how to care for your exit site and keep your catheter free from bacteria. If problems do occur, contact your GP or kidney unit straightaway. The sooner an infection is treated, the less likely it is to affect your CAPD or require your admission to hospital.
Other possible problems could include:
- blockages in the catheter
- hernias (a lump in the abdomen) which can be caused by an internal part of the body (such as an organ) pushing through weakened stomach muscles.
But your medical team will be able to help you if these do occur.
How will CAPD make me feel?
CAPD is not generally painful but some people find it uncomfortable to have fluid in their abdomen.
You may feel anxious, angry and upset about the upheaval to your personal, home, work and family life as you face the prospect of multiple daily CAPD sessions. This is all perfectly normal so talk to your kidney doctor or nurse about any concerns that may be affecting you physically and psychologically. They may also be able to put you in touch with a counsellor who can help you with your mental wellbeing, (link to ‘mental wellbeing’ page in ‘how can I help myself?’ section)
Take a look at our Dialysis Decision Aid booklet for more information about CAPD and other types of treatments generally available to people with kidney failure.
The booklet has space for your own notes and some suggestedKR-decision-aid-colour July2015 prompts to help you raise any issues that may be concerning you.
You can also find further advice and helpful tips in our How can I help myself? section.
Reviewed April 2019
The need for more research
We know there are significant variations between kidney units in the chances of a patient starting CAPD, and in the number of patients who have to switch to haemodialysis. Research is needed to understand and resolve these differences. We also need to investigate ways to improve mortality rates and quality of life for people on dialysis.
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