Peritoneal dialysis (PD) is a treatment for kidney failure. It cleans your blood when your kidneys can no longer do the job on their own.

PD uses the lining of your belly (called the peritoneum) as a natural filter. A soft tube called a catheter is placed in your belly during a small surgery. A cleansing fluid called dialysate is put into your belly through the catheter. The fluid draws out waste and extra water from your blood. After a set amount of time, the used fluid is drained and replaced with fresh fluid. This process is called an exchange.

PD is done at home. It gives you more control over your schedule than going to a dialysis center.

Before you start PD, a surgeon places a catheter in your belly. The catheter stays in place and is used for every fluid exchange. Your care team will train you before you start doing PD at home.

There are two main types of PD:

• Continuous ambulatory peritoneal dialysis (CAPD): You do exchanges by hand, several times a day. You are not attached to a machine. Each exchange takes about 30 to 40 minutes. Most people do 3 to 5 exchanges a day.
• Automated peritoneal dialysis (APD): A machine called a cycler does the exchanges for you, usually overnight while you sleep. You are connected to the machine for about 8 to 12 hours at night.

Your care team will help you decide which type works best for your health and lifestyle.

PD has several advantages:

• You can do it at home, at work, or while traveling.
• You don't have to go to a dialysis center several times a week.
• APD can be done overnight, keeping your days free.
• Fluid is removed slowly and gently, which may be easier on your heart.
• You may have fewer diet restrictions than with hemodialysis.
• It may help preserve your remaining kidney function longer.

PD requires daily commitment. There are also some risks to know about:

• Exchanges must be done every day. Skipping them can be harmful to your health.
• There is a risk of peritonitis, an infection of the belly lining. This is a serious complication of PD.
• The catheter site needs daily cleaning to prevent infection.
• You will need a clean, secure, and safe space at home, away from pets, to store supplies.
• Weight gain is possible because the dialysate contains a type of sugar your body can absorb.
• Some people find it hard to manage PD without support from a caregiver.

PD isn't right for everyone. Certain belly conditions or past surgeries can make it hard. Talk to your care team about whether it's a good option for you.

Contact your doctor now or seek immediate medical care if:

• You have symptoms of infection around the catheter, such as redness, swelling, warmth, or pus.
• You have a fever.
• You have nausea or vomiting.
• Your used dialysis fluid looks cloudy or unusual.
• You have trouble having a bowel movement or passing gas.
• You have belly pain or tenderness.
• You accidentally contaminated the catheter, tubing, or connection.

Watch closely for changes in your health, and be sure to contact your doctor if:

• You have itching, diarrhea, constipation, or confusion that is severe or lasts more than 2 days.