Renal Replacement

Question 1

Peritoneal dialysis (PD).

What are the 2 types?

Answer 1

Continuous Cycling Peritoneal Dialysis (CCPD)

Continuous Ambulatory Peritoneal Dialysis (CAPD)

PD uses the patient’s own membrane, the peritoneum, to clean the blood.

Done 24/7 at home. PD fluid (which contains Dextrose as the osmotic agent) is instilled into the peritoneal cavity for a period of time (“dwell time”) then drained and refilled again.

This is called an “exchange” and it is performed continuously by the patient himself using a permanent catheter surgically implanted in his abdomen.

Question 2

Hemodialysis (HD)

Answer 2

uses an access where blood is removed from the body, cleaned and then returned to the body.

HD is generally performed 3-5 hours, 3 days a week.

It can be done at home or in an outpatient clinic.

It requires a machine, cleaning fluid (dialysate) and an access.

Question 3

Transplant

Answer 3

patient has another kidney surgically implanted in his abdomen.

This requires an intense workup, a donor, and anti-rejection drugs for the life of that kidney.

Question 4

Hospice

Answer 4

no treatment, goal is to keep patient comfortable – will result in death.