Peritoneal Dialysis
When people hear that Dylan is on dialysis, most think of hemodialysis because that’s the most well known. Peritoneal dialysis is quite different and allows us to be at home while giving treatment. However, it is a lot of work and there’s a lot that goes into it daily. Thankfully, peritoneal dialysis does not require central lines that need to be maintained. It does require a catheter that is placed into the peritoneum in the abdomen to allow dialysis fluid to enter and exit. Here’s a brief description of our daily routine while being on peritoneal dialysis:
Dylan wakes up and needs to be disconnected from his dialysis. This requires a mask to be put on and hand washing for 1 minute. The catheter is locked, disconnected from the line, and a cap with iodine is placed on the end to keep it clean throughout the day. The numbers from his dialysis from overnight are recorded in a log book.
Once dialysis is disconnected, the overnight feed is also disconnected. Dylan is g-tube fed an overnight feed to help get some extra calories in and make sure he gets enough fluid to keep hydrated.
Once fully disconnected from everything, Dylan gets weighed. This needs to be a naked weight as it is the most consistent to make sure that he is not too dry nor did he retain too much fluid from his dialysis overnight. A blood pressure is also done if we have a nurse working with us that day.
Dylan’s bandage on top of the catheter is changed and an antibiotic cream is put on the exit site to help prevent an infection from occurring. He also has a stat-lock that helps hold the catheter in place so it cannot be pulled. This only needs to be changed when it’s pulled off but I always check it as Dylan is very good at ripping it off!
At some point throughout the day, either Brian, myself, or our nurse, will set up dialysis so it is ready for that night.
The dialysis solution bags, waste bag, cassette and tubing all need to be emptied and discarded from the night before. We cut the bags open and dump them in the bath tub and then flush it with lots of water. All this gets thrown in the garbage.
Once the dialysis machine is on and ready, we insert a new cassette, connect it to a waste bag and it does a pressure test. While this is happening, we clean the surface of our cart with alcohol and pull out the dialysis solution bags we will be using that night. We put a mask on and do another 1 minute hand wash before connecting the bags. This then does a prime through the lines.
Dialysis is now ready for us to connect Dylan that night when he goes to bed, which also requires a mask to be worn and a 1 minute hand wash. Dylan’s current orders are to receive dialysis overnight for 10 hours, which requires 8 cycles of fluid going in and out of his peritoneum. Some nights go well, other nights can be full of troubleshooting as to why the dialysis machine is beeping.
We had to rearrange Dylan’s room and purchase a cart that would work for everything we needed. The dialysis machine has to be the same height as the crib bed where Dylan would be sleeping. This took some time to find ones with the proper height. No pets are aloud in Dylan’s room as pet dander can potentially cause peritonitis, which we would never want, so Dylan’s room is always closed. His closet is full of boxes containing supplies and dialysis solutions. On top of all of this, Dylan receives medications through out the day and his g-tube feeds. While this is a very brief summary of our routine doing dialysis, our days can be quite exhausting!
