APD: Automated Peritoneal Dialysis

APD uses a machine (sometimes called a cycler) to perform the fluid exchanges. APD machines are simple and safe to operate. They can be used anywhere there is a supply of electricity.

Here is how it works: you prepare the machine's supplies before you go to bed. When you go to bed, you connect the catheter to the APD machine's tubing and switch the machine on. The APD does your exchanges automatically over 8 to 10 hours while you sleep. During this time, the APD machine
• warms the fluid,

• carefully measures the amount of fluid that goes in and out of the peritoneal cavity,

• drains used solution out of your body,

• fills your peritoneal cavity with fresh solution,

• and makes sure these exchanges happen at the right time (between 3 to 5 times a night).

In the morning, you disconnect the catheter from the machine. Most people need to leave the fluid from the last exchange in their abdomen during the day. Some patients may need to perform an additional exchange during the day, to make sure they get enough dialysis.

APD is better for some patients because they have most or all of their day free. It may be better for people who have to go to work or school every day.

Another advantage of APD is that it helps dialysis work better for some patients because the fluid is left inside the peritoneal cavity for a shorter time. This is easy to accomplish at night, when the machine does the work for you. Since patients on CAPD do the exchanges themselves during the day, they usually leave the fluid inside for longer periods.

For both types of peritoneal dialysis, your doctor will write a prescription for your supplies and your nurse will teach you how to order. All the supplies needed for peritoneal dialysis can be delivered to your home. Deliveries are scheduled so that you should not run out. The driver is responsible for moving all the boxes, and patients soon get to know their regular driver well.

A large area is needed to store the supplies. An extra closet or basement is perfect, as long as the area is not too hot or damp.