What Is Peritoneal Dialysis?

Can dialysis really happen in your own living room, without a machine full of blood tubes? For many people with kidney failure, yes — and the "filter" it uses is one you already carry with you: the lining of your abdomen. Peritoneal dialysis, usually shortened to PD, is the home-based form of dialysis described on our dialysis condition hub. The short video at the top of this page, "Peritoneal Dialysis for Kidney Disease" (just over a minute long), gives the overview; the questions below walk through how it works in practice, one answer at a time.

First, what problem is PD solving?

Healthy kidneys quietly filter waste and extra fluid from your blood around the clock. When the kidneys fail — the situation explained in our guide to kidney failure — those wastes build up, and some form of kidney replacement is needed. Dialysis does part of the kidneys' filtering job artificially. Our earlier guide to how dialysis works covers both main forms; this article is about the one that uses your abdomen instead of an external filter. If you are tracking kidney function numbers with your team, our eGFR calculator can help you follow the estimate they talk about — though the decision about when dialysis is needed is always a clinical one, made with your own doctors, not from a calculator alone.

So how does fluid in the abdomen clean the blood?

Your abdomen is lined by a thin membrane called the peritoneum. It is rich in tiny blood vessels, and it behaves like a natural sieve. In PD, a sterile cleansing fluid — dialysate — is run into the space inside the abdomen through a soft tube, and left there for a set period called the dwell. While the fluid sits there, waste products and extra water pass from the blood in those tiny vessels, across the membrane, into the fluid. When the fluid is drained out again, the waste leaves with it. Fresh fluid then goes in, and the cycle repeats. Each full cycle of filling, dwelling and draining is called an exchange.

It is a gentle, continuous style of cleaning rather than a fast one. Because exchanges happen every day, the levels of waste and fluid in the body tend to stay steadier than with treatments done only a few times a week — one reason some people find the rhythm easier to live with.

What is the catheter, and how does it get there?

PD needs a permanent, soft tube — a catheter — that passes through the abdominal wall so fluid can flow in and out. It is placed in a planned procedure, usually with an anaesthetic, and a short length of tube remains outside the skin, where it is kept covered and protected between exchanges. The second video on this page shows exactly that placement step: "One port laparoscopic technique of peritoneal dialysis catheter placement" (about five minutes) follows a keyhole approach in which the surgeon uses a single port rather than the several ports older techniques needed, precisely to reduce strain on the abdominal wall. You do not start exchanges the day the catheter goes in — the site is given time to heal first, and your dialysis team will tell you when, and will train you before you do anything on your own.

What does a normal day on PD actually look like?

That depends on which of the two patterns your team recommends. With continuous ambulatory PD (often called CAPD), you do the exchanges yourself by hand during the day: a bag of fluid drains in by gravity, you go about your life while it dwells, then you drain it out and start the next exchange. No machine is involved, and each exchange itself takes a modest part of the day. With automated PD (APD), a small machine called a cycler does the exchanges for you overnight while you sleep, leaving the daytime freer. Both patterns use the same fluid, the same membrane and the same catheter — the difference is who, or what, runs the cycles, and when.

Whichever pattern you follow, training comes first. Dialysis nurses teach the routine step by step — hand hygiene, keeping connections clean, checking the drained fluid, keeping simple records — and you practise under supervision until the team is confident, and so are you. Supplies are delivered to your home, and you will have regular clinic reviews, blood tests and a named team to phone. It is home treatment, but it is not treatment alone.

How is PD different from haemodialysis?

In haemodialysis, blood is taken out of the body, passed through a filter in a machine, and returned — most often in a dialysis centre, a few times a week, over several hours. In PD, the filtering happens inside your body, at home, every day, and no blood leaves the body at all. Neither is simply "better": they differ in schedule, in where treatment happens, in the access they need (a catheter in the abdomen for PD, a blood-vessel access for haemodialysis), and in the daily routines they ask of you. Some people start on one and later move to the other, and for some, dialysis of either kind is a bridge to a kidney transplant. Which options are open to you depends on your health, your abdomen and your circumstances — a conversation for your kidney team, who know your scans and your history.

What can go wrong, and what should you watch for?

The complication PD teams talk about most is infection of the abdomen, called peritonitis. The drained fluid normally comes out clear; if it looks cloudy, or you develop abdominal pain, fever, or redness and soreness where the catheter leaves the skin, that needs prompt attention from your dialysis team — not a wait-and-see approach. This is why the training puts so much weight on clean technique: careful hand washing and sterile connections are not fussiness, they are the main protection.

Other issues are more mechanical. The catheter can drain slowly if it shifts position or becomes blocked, fluid can leak around the site, and hernias can occasionally develop because fluid in the abdomen raises pressure there. Over a long period, the membrane itself can gradually become less efficient, which is one reason the team monitors how well your exchanges are working and may adjust your prescription or discuss a change of treatment. None of this is a reason to be frightened of PD — it is the list your team will already have in mind at every review, and most problems are easier to sort when they are reported early.

A realistic way to picture it

Think of PD as moving a slow, steady version of the kidneys' filtering into your own home and your own daily routine. It asks something of you — training, tidiness with technique, storage space for supplies, and the discipline of daily exchanges — and in return it gives many people treatment that fits around work, family and sleep rather than around a centre's timetable. If it has been offered to you, ask your team the practical questions early: which pattern, what training, who to call at night, and how it would fit your life. Those answers, for your situation, are what turn a general explanation like this one into a decision you can feel settled about.

References & further reading

- MedlinePlus — Dialysis (summary, including peritoneal dialysis): https://medlineplus.gov/dialysis.html
- MedlinePlus — Dialysis - peritoneal (Medical Encyclopedia): https://medlineplus.gov/ency/article/007434.htm
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) — Peritoneal Dialysis: https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/peritoneal-dialysis

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Frequently Asked Questions

Is peritoneal dialysis painful?
The exchanges themselves should not be painful. You may feel fullness while fluid is in the abdomen, and the catheter placement procedure is done with an anaesthetic. New pain, especially with cloudy drained fluid or fever, should be reported to your dialysis team promptly.

Do I have to do PD forever?
PD is one of several kidney replacement options. Some people stay on it for years, some later move to haemodialysis, and some receive a kidney transplant. Your team reviews how well it is working for you over time.

Can I travel while on PD?
Many people on PD do travel, with planning: supplies can often be arranged ahead, and your team can advise on what to take and how to keep exchanges clean away from home. Ask your unit well before any trip.

What is the difference between CAPD and APD?
Both use the same fluid and catheter. With CAPD you perform exchanges by hand during the day; with APD a cycler machine performs them overnight while you sleep. Your team will discuss which pattern suits your health and your routine.

What should I do if the drained fluid looks cloudy?
Contact your dialysis team promptly. Cloudy fluid, abdominal pain, fever or redness at the catheter site can be signs of infection, which is treated most easily when it is caught early. Do not simply wait for the next routine review.

This article is for general education only and is not medical advice. It does not replace consultation with a qualified clinician. Decisions about dialysis are individual and should be made with your own treating team.

Dr. Mohamed Ibrahim, MD, PhD

Physician-scientist · Founder, MedicalVideos.com

Dr. Ibrahim founded MedicalVideos.com in 2007 to make medical and surgical education freely accessible to students, clinicians, and patients.

Last reviewed: 11/15/26