Getting to know CAPD, Method of Washing Blood Through Stomach

CAPD ( continuous ambulatory ) is a dialysis method performed via stomach. as natural filters when passed by residual substances .

Washing blood is useful for cleaning blood from metabolic waste, electrolytes, minerals, and excessive fluids due to decreased kidney function. In addition, dialysis can also help control blood pressure.

Getting to know CAPD, Method of Washing Blood Through Stomach

Preparation Before CAPD

Patients are required to undergo catheter insertion surgery first. This catheter will be useful as a place for the entry and exit of dialysis fluid, which is a sterile liquid to attract metabolic waste, minerals, electrolytes, and water from the body.

In catheter placement surgery, the surgeon will make a small incision (usually next to the underside of the navel), after the patient is given general or local anesthesia. From the incision, a catheter is inserted until it reaches the abdominal cavity (peritoneal cavity).

After the operation is completed, patients may be required to undergo overnight stays. However, most can go straight home.

Although dialysis can be done immediately after the catheter is installed, the catheter will work better if the surgical wound heals first, which is within 10-14 days or up to 1 month.

You will be taught by nurses about how to properly exchange fluids and how to avoid infection. After 1-2 weeks undergoing CAPD with the help of nurses, patients are usually able to do it yourself at home.

How is the CAPD done?

First of all, the patient needs to place a bag filled with dialysis fluid at shoulder height. The liquid is then inserted into the abdominal cavity with the help of gravity.

After the dialysis fluid has fully entered the abdominal cavity, the catheter must be closed and the patient can move and carry out daily activities as usual.

After 4-6 hours, dialysis liquid containing residual substances can be flowed out of the abdominal cavity, to then be discharged into the toilet or bathroom. CAPD can be done 3-6 times a day, with one fluid filling before going to sleep.

CAPD Advantages

CAPD has almost the same effectiveness as hemodialysis (HD). However, there are several advantages of CAPD when compared to HD, including:

  • There is no drastic change in blood flow that usually occurs in hemodialysis, so the burden on the heart and blood vessels is lighter.
  • Use of less drugs.
  • More flexible and independent. Machine dialysis is generally done in a hospital or hemodialysis center, while CAPD can be done anywhere as long as it's clean. In addition, the time needed for the exchange of fluids is not long, so you can still move as usual, work, or travel. Before leaving for your destination, make sure the equipment needed for fluid exchange is ready.
  • Food and drink limits are not as strict as for patients undergoing hemodialysis, because the process of dialysis through the stomach can be done more frequently.
  • Kidney function may be sustained longer.
  • There is no need to receive a needle or IV needle.
  • Fewer problems for anemic patient.
  • Lower mortality rate.
  • The risk of dementia is lower.

CAPD Disadvantages

CAPD is not necessarily right for all sufferers of kidney failure. Conditions that make dialysis difficult or impossible to do are:

  • Obesity or overweight.
  • Have had stomach surgery a number of times or there is a large surgical scar on the stomach.
  • Hernia, Crohn's disease, ulcerative colitis, bacterial infection of Clostridium difficile, colon cancer, and end-stage liver disease with ascites.
  • There is a hole or stoma in the abdomen (ileostomy or colostomy).
  • Not able to take care of themselves or limited help from others.

CAPD Risk

Even though all dialysis methods have risks or side effects, there are some conditions that are more prone to occur due to CAPD, such as:

1. Hernias

The presence of holes in the abdominal muscles into which the catheter enters and the pressure from the abdominal cavity due to dialysis fluid can result in the appearance of a hernia near the navel, groin, or near the catheter entry site.

2. Increase in body weight and blood sugar levels

Dialysis fluid contains sugar which can be absorbed by the body, so the patient is at risk of gaining weight and diabetes.

3. Stomach enlarges

As long as the dialysis fluid is in the stomach, the stomach may enlarge and feel like bloating or fullness. However, it is generally not to cause pain.

4. Indigestion

Patients who undergo CAPD are more often experiencing digestive problems, such as stomach acid disease (GERD), heartburn (dyspepsia), intestinal obstruction (intestinal obstruction), or intestinal adhesions, than patients who undergo hemodialysis.

5. Infection

The most serious complication is infection. Infection can occur in the skin around the site of entry of the catheter or in the abdominal cavity (peritonitis) due to the entry of germs through the catheter.

Symptoms of a skin infection include redness, suppuration, swelling, and tenderness at the site of the catheter. While peritonitis can cause symptoms in the form of:

  • Abdominal pain
  • Fever
  • Nausea and vomiting
  • Used dialysis fluid is turbid
  • The catheter is pushed out of the stomach

Dialysis can help reduce complaints and extend life expectancy, but it cannot treat kidney failure. Consult with a specialist in internal medicine regarding the selection of dialysis methods that are right for you, including CAPD, taking into account the advantages and disadvantages.

Written by:

dr. Michael Kevin Robby Setyana.

Label : Health cat_Health

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