Makindo Medical Notes | Continuous Ambulatory Peritoneal Dialysis (CAPD)

CAPD is a form of dialysis for kidney failure where the peritoneum acts as a natural semi-permeable membrane to filter waste and excess fluid. It can be done at home and gives patients more independence compared to haemodialysis.

Indications 🩺

Chronic kidney disease (CKD) stage 4–5 when haemodialysis is unsuitable.
Patients who prefer home-based or flexible dialysis schedules.
Difficult vascular access for haemodialysis.
Children and patients wanting more lifestyle independence.

The CAPD Process 🔄

Access: A Tenckhoff catheter is surgically placed in the peritoneal cavity.
Dialysate: Sterile solution (usually glucose-based) is infused into the peritoneal cavity.
Dwell Time: Fluid remains in place for 4–6 hrs, during which diffusion and osmosis remove urea, creatinine, and water.
Drainage: Used dialysate is drained and replaced with fresh solution.
Typical Schedule: 3–5 exchanges daily, each taking 30–40 min.
Automated PD: Can also be done overnight using a machine (APD).

Complications ⚠️

Peritonitis 🤢: Abdominal pain, cloudy effluent, fever. Treat with intraperitoneal antibiotics; prevention relies on aseptic technique.
Catheter problems: Blockage, displacement, infection → may need revision.
Fluid overload 💦: If ultrafiltration inadequate, use hypertonic dialysate bags.
Electrolyte imbalance: Regular monitoring required (esp. K⁺, Ca²⁺, phosphate).
Other: Constipation, pleural effusion, leakage into scrotum, rare sclerosing peritonitis.

Advantages ✅

Can be done at home or work → promotes independence.
Gentle, continuous therapy → fewer swings in electrolytes and fluid balance.
No vascular access needed (avoids fistula/graft complications).

Disadvantages ❌

High risk of peritonitis and exit-site infection.
Requires patient motivation, dexterity, and strict asepsis.
May be less effective in some patients (esp. with adhesions or large body size).

Summary 📝

CAPD uses the patient’s peritoneal membrane as a natural dialysis filter. It provides independence and flexibility but comes with risks of infection and fluid complications. Choice between CAPD and haemodialysis depends on patient suitability, lifestyle, and medical considerations.

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Continuous Ambulatory Peritoneal Dialysis (CAPD)

Continuous Ambulatory Peritoneal Dialysis (CAPD) 💧