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The Peritoneal Dialysis (PD) Unit of the National Kidney & Transplant Institute(NKTI) is the largest in the Philippines. It is the leading facility in providing peritoneal dialysis therapy and is fully equipped to treat all kinds of patients who may need PD therapy. The PD Unit is one of the critical areas of the Institute, handling patients on various types of peritoneal dialysis. Peritoneal dialysis is another form of dialysis where the patient’s own peritoneal membrane (or lining of the abdominal organs and body surfaces within the abdominal cavity) acts as the artificial kidney. There is no blood removed or returned to the patient. Dialysis using the peritoneal membrane is also a means to remove toxins, poisons and excess fluid that accumulates in the body when patients’ kidneys are no longer able to function adequately.

Peritoneal dialysis can be performed when there is an acute deterioration in kidney function, such as with severe blood loss or severe dehydration due to vomiting and diarrhea. It can also be used for gentle fluid removal in patients with non-primary kidney disease, such as patients with congestive heart failure or cirrhosis of the liver. In these cases, dialysis may be necessary only for a short period, giving the patient’s kidneys time to recover from the sudden and severe situation that caused it to fail temporarily.

It can also be used to permanently replace a patient’s kidney function in patients with longstanding kidney disease. These include longstanding hypertension and diabetes mellitus which are common causes of kidney failure in Filipinos. It can also be used in place of the kidneys for patients with primary kidney disease such as chronic glomerulonephritis when kidneys are no longer able to perform their function sufficiently well.

Majority of the patients are on Continuous Ambulatory Peritoneal Dialysis (CAPD) since this is the more physiologic type of dialysis and provides the best clearance.

One of the programs of the unit is the CAPD Training for CAPD patients. This training programs is devised for patients diagnosed to have End Stage Renal Disease (ESRD) who are about to undergo Peritoneal Dialysis. This requires admission for a period of 3 days where a series of lectures and return demonstration of the desired CAPD system is performed.

Services

Insertion the Acute or Permanent PD Catheter

Highly trained surgeons place the PD catheter into the abdominal cavity of the patient. The acute PD catheter is used for patients who need PD treatment only for a short period. It is a stiff catheter. The permanent PD catheter is a soft pliable tube that is used for the lifetime of the patient. Both catheters provide access for the infusion and drainage of the special PD fluid or solution. Placement of the PD catheter is only a 30-minute procedure performed under local anesthesia in the strictly sterile environment of the operating room. As soon as the catheter is placed it can be used immediately to perform PD.

This is a chronic type of PD therapy where patients are trained to perform the dialysis themselves in the comfort of their homes. It is a continuous type of treatment because there is always PD fluid inside the peritoneal cavity where dialysis is continuously occurring. It is ambulatory because while the PD fluid is inside the body, the patient is free to do his daily activities. The patient can go to work or just stay at home and do their usual activities.

Intermittent PD (IPD)

This can be performed for both acute and chronic kidney failure. PD exchanges are performed every 30 minutes in order to quickly remove the poisons and excess fluid that have accumulated in the body because the kidneys were not performing adequately. It can be done by the PD nurses every 30 minutes or the patient can be hooked to a special PD machine called the cycler. The PD solutions are connected to the cycler, and a special tubing from the cycler is connected to the patient?s PD catheter. The machine is turned on and the cycler begins the dialysis therapy. IPD is usually performed from several hours to several days, depending on the needs of the patient.

Continuous Cycler-Assisted PD (CCPD)

PD therapy can also use a combination of the cycler machines and manual PD exchanges. This is called CCPD. It is continuous because there is always PD solution inside the peritoneal cavity. The cycler is used to do several short exchanges during the night while the patient is asleep, and 1 to 2 manual exchanges are performed by the patient during the day. Special PD trainors train the patient, their relatives or caregivers to perform this type of therapy. When the PD therapy is performed only at night and the patient does not have any PD solution inside the body during the daytime, it is called NOCTURNAL INTERMITTENT PD (NIPD). Your physician will decide which type of therapy you need. All of these types of PD therapy are available at the NKTI. The Unit has a medical and nursing staff especially trained to perform PD and has a specific program for training patients in using PD. The Unit also has specialized PD technicians and clinical nursing assistants who assist in the performance of PD throughout all areas of the hospital.

Facilities

PD MAIN

• Located at the back of Wing 2D and 2C

• 10-beds for in-patients

• Special area for CAPD

CAPD Center

• Located at 2nd Floor of the Dialysis Building

CAPD Out-Patient Clinic

• Conducts out-patient clinic visits

• Performs patient-related PD activities such as exit site dressing, change of PD transfer set, prescription of dialysis needs.

Cycler Assited IPD

• 4-bed capacity for out-patient cycler-assisted PD therapy

Although there are 2 main areas for PD, patients may be admitted anywhere in the hospital for their PD therapy. The PD Unit staff supervises all the PD therapy being perfomed throughout all the areas of the hospital.
 

Patient's Benefits

• Senior citizen discounts, direct government employee discounts

• HMO

• PCSO, PAGCOR and PNP assistance

• Discounts for patients qualified for social service assistance

• Philhealth – SOON !

Our Expert Team

Contact Us

FAQ's

Question:

What is Peritoneal Dialysis?

Answer:

Peritoneal dialysis is a form of therapy that replaces a patient’s kidney function. It uses the patient’s own peritoneal membrane to act as the artificial kidney. A special type of fluid called peritoneal dialysis fluid enters the patient’s abdominal cavity through a surgically placed PD catheter. It stays inside the abdominal cavity where it lies in contact with the peritoneal membrane. During this time, poisons, toxins, and excess fluid which are found in abundance in the blood of a patient with kidney failure will transfer from his blood to the PD fluid. After 6 to 8 hours, the PD fluid will be drained via the PD catheter, containing many poisons, toxins, and excess fluid. This is how the blood is cleaned of all the toxic substances that accumulated because the kidneys were no longer functioning adequately. After draining the fluid, fresh solution will be infused into the abdominal cavity again through the PD catheter. This cycle is repeated from 3 to 4 times each day everyday.

Question:

What are the advantages of doing PD? Is it right for me?

Answer:

The major advantage of doing PD is that the patient and/or caregivers are trained to perform PD at home. There is no need to go to a hemodialysis center in a hospital or clinic for 4 hours, 2 to 3 times a week. Dialysis using PD can be performed in the comfort of one’s bedroom, or in the office. All the patient needs is a clean room with adequate ventilation. The patient is therefore more mobile with freedom to travel. If one is planning to go to a different city for a vacation, there is no need to make reservations at an HD center. The patient just brings his required number of PD dialysis fluid bags and off they go to their city of choice.

PD is especially appropriate for children who may not have suitable veins large enough for the HD needles. They can grow up in the warm environment of home, without the memory of doing therapy in the hospital.

Elderly patients, or patients with significant heart disease may feel better on PD therapy because it is a gentler form of dialysis which is performed daily, every day. They will not be subjected to the severe drops in blood pressure associated with HD treatment when blood exits from the arm even though it is returned to the patient.

PD is appropriate for any patient as long as their peritoneum is working properly. Patients who have had previous abdominal surgeries like surgery for a ruptured appendix or an operation to remove a gall bladder, or a previous childbirth by ceasarian section may not be suitable because the peritoneal membrane may have developed adhesions (or scar tissue) as a result of the operation. Once the peritoneal membrane is replaced by scar tissue, it can no longer function adequately as an artificial kidney. Discuss this concern with your physician! Your doctor will help you make the best decision on your choice of dialysis therapy. 

PD can be performed by anyone, from an adolescent to an elderly patient. The steps are easy to perform and the PD tubings and bags very simple to use. Remember, they were made especially to be used by ordinary men, women and children. We have an expert training team who will teach the patient, relatives and caregivers all the steps in performing peritoneal dialysis. 

Question:

What is the Peritoneal Membrane?

Answer:

This is the lining of the abdominal organs such as the stomach and intestines, liver and spleen and lining the body wall. It acts as the artificial kidney during peritoneal dialysis. It allows the passage of toxins such as excess urea, creatinine, and potassium which accumulate in patients with kidney failure. It also allows excess water to be removed from the body in patients who have leg edema, and fluid in the lungs. This can happen in patients with kidney failure who can no longer urinate sufficiently.

Question:  

What is a PD Catheter?

Answer:

The PD catheter is a pliable tubing about 12 inches long which is surgically placed inside the abdomen. In patients with kidney failure it is placed only once and lasts the lifetime of the patient. It is the permanent access where the PD fluid will enter and exit from the patient’s abdomen in order for peritoneal dialysis to be performed. About 5 inches of tubing may be seen exiting from the abdomen.

Question:

What is PD Fluid or PD Solution?

Answer:

PD fluid is a special type of fluid, similar to the dextrose fluid given intravenously. It contains electrolytes which are usually lacking in a patient with kidney failure, such as calcium, and has dextrose which acts to remove fluid from the body.

Question:

What is a PD Exchange? 

Answer:

A PD exchange is the process of infusing PD solution into the peritoneal cavity via the PD catheter and then draining it after several hours. Fresh PD solution is infused into the peritoneal cavity of the patient by connecting the dialysis fluid tubing to the patients PD catheter. The PD solution stays inside the peritoneal cavity where it lies in contact with the peritoneal membrane which now acts as the artificial kidney. Toxins and poisons from the blood enter into the PD solution, as well as the body’s excess fluid. After about 6 to 8 hours, the PD solution containing the toxins is drained from the peritoneal cavity into the empty drain bag, and fresh PD solution is infused again. The used tubings and spent dialysis fluid (fluid containing all the toxins) is then disconnected from the patient and discarded. This is performed 3 to 4 times a day, everyday. One exchange takes about 20 minutes; 10 minutes to infuse fluid and 10 minutes to drain it.