Helpful tips for peritoneal dialysis (PD)

Discomfort when solution flows in

Possible causes:

Temperature of the dialysis solution
pH of the PD solution
Catheter position (mechanical)

What to do:

Check whether the solution is warm enough. Warm the solution to body temperature. (If you use the cycler, the cycler will warm the solution to body temperature.)
Change your position during infusion (when solution is flowing in).
Talk to your nurse about the discomfort during therapy.
Your nurse may assess your catheter placement.
There are other options for PD solutions that could help with your discomfort during infusion. Ask your doctor or your nurse for further information.

Dialysis solution does not flow in or out

Always contact your healthcare provider first. Below are possible causes and what to do:

One or more clamps on the transfer set, continuous ambulatory PD (CAPD) bag lines, or automated PD (APD) systems set may be closed	Check to make sure all the clamps are open and the frangibles are broken.
The tubing catheter is kinked	Straighten out the tubing and the catheter.
The bag is not connected properly	Push the luer all the way into the bag luer port.
The catheter, tubing, or frangible is blocked by fibrin	Gently squeeze the line or bend the frangible back and forth to loosen the fibrin and allow the fluid to pass. Complete your exchange and call your nurse to report fibrin presence.
Constipation	Constipation can be prevented by eating a healthy diet, exercise, and the use of prescribed bowel medicines. Change your position to see if the flow of PD solution changes. If it does not help the flow, contact your clinic.
Air in the solution line	Air can block the flow of solution. Close the transfer set clamp and gently squeeze the solution bag. This should move the air out of the line. Open the transfer set clamp and let the solution flow in.

Drainage solution looks different

There are times when the drained fluid is not clear. There are reasons why this may happen.

Drained fluid is cloudy	Call your clinic immediately. Do not wait for the next exchange. Save the fluid in the drain bag.
The drained fluid is dark yellow	The PD solution may have been left in the peritoneal cavity longer than usual. Dark yellow fluid may contain more waste products than normal.
Drained fluid has white strands in it	This is an indication of fibrin. If fibrin is seen several times, notify your nurse.
Drained fluid is pink	This is an indication of a small amount of blood in your peritoneal cavity. Notify your nurse.
Drained fluid is dark red or bloody	Contact your nurse. If the pink color gets darker or does not go away, call your clinic immediately.
Heavy lifting or strenuous exercise	Avoid heavy lifting or strenuous exercise. If the pink color gets darker or does not go away, call your clinic immediately.

Peritonitis

Peritonitis is an infection caused by germs in the peritoneal cavity. Most peritonitis events are preventable if you do your exchanges as you were taught every time.

What can you do to help prevent peritonitis?

Good handwashing and drying
Good dialysis technique
Good exit-site care
Avoid constipation

Consult your nurse if you have questions or think you have made an error in your technique.

Signs of peritonitis include:

A cloudy bag
Abdominal pain
Fever
Feeling unwell
Diarrhea

Call your unit immediately—peritonitis will NOT go away by itself and is a serious condition.

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