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Preface and Contents

Dialysis

Automated peritoneal dialysis

76. Save Your Kidneys

3. APD or Continuous Cycling Peritoneal Dialysis (CCPD):

Automated peritoneal dialysis (APD) or continuous cycling peritoneal dialysis (CCPD) is a form of PD treatment done at home using an automated cycler machine. The machine automatically fills and drains the PD fluid from the abdomen. Each cycle usually lasts for 1-2 hours and exchanges are done 4 to 5 times per treatment. The treatment lasts about 8 to 10 hours, usually at night, while the patient is asleep. In the morning, the machine is disconnected and 2 to 3 liters of PD fluid are usually left in the abdominal cavity. This fluid is drained the following evening before the next treatment is started. APD is advantageous since it allows the patient to go about regular activities during the day. Also, since the PD bag is connected and detached from the catheter only once a day, the procedure is more comfortable and carries less risk of peritonitis. However, APD may be expensive in some countries and can be a rather complex procedure for some patients.

What is PD fluid used in CAPD?

PD fluid (dialysate) is a sterile solution containing minerals and glucose (dextrose). Glucose in the dialysate allows removal of fluid from the body. Depending on the concentration of glucose, there are three kinds of dialysate available in India and in most areas worldwide (1.5%, 2.5% and 4.5%).The glucose concentration is selected for individual patients depending on the amount of fluid that needs to be removed from the body. Newer PD fluids are available in some countries which contain icodextrin instead of glucose. Icodextrin-containing solutions remove body fluids more slowly and are recommended for diabetic or overweight patients.

CAPD solution bags are available in different volumes ranging from 1000 to 2500 ml.

Continuous Cycling Peritoneal Dialysis is carried out at home with an automated cycler machine.