What Is Automated Peritoneal Dialysis?

Starting dialysis is a major life change, but technological advances have changed the dialysis landscape, giving you the option to dialyze in the way that fits your lifestyle. Increasingly, people are choosing to dialyze from home, using one of several different home dialysis methods. One such treatment is automated peritoneal dialysis (APD). APD can be done at night while you sleep, allowing you to go about your day.  

Like peritoneal dialysis (PD) in general, automated peritoneal dialysis is typically done at home and prescribed treatments are typically more frequently than in-center dialysis. As a result, waste and toxins in your blood don’t have as much time to build up between treatments, leaving you more energized and ready to tackle each day. PD is considered a gentle form of dialysis that uses the blood vessels in the lining of your abdomen—your peritoneum—to filter waste from your blood.

While treatment schedules may vary, APD is designed to be done daily. You’ll attach a continuous cycling machine, or cycler, to your peritoneal catheter. The cycler will pump a dialysate fluid into your peritoneal cavity, where it “dwells” long enough for it to clean your blood and remove excess fluid. Then, the solution drains. Each cycle of fill, dwell, and drain is called an exchange.

Your cycler will repeat this process until you’ve completed the number of exchanges prescribed by your nephrologist, possibly 3 to 5 times per day. Completing these exchanges with the cycler usually takes 8 to 10 hours, which is why many people do it while they sleep.

PD is considered the most similar dialysis method to natural kidney function. People on PD generally have fewer dietary restrictions and medications compared to other types of dialysis.

All forms of PD require a peritoneal catheter. You’ll need a minor surgery to have the catheter placed, and you’ll have to keep the area clean to avoid possible infections. The catheter is usually placed in the abdomen. Be sure to discuss with your surgeon any lifestyle habits that would require an alternative placement, such as whether you wear a belt and if your job requires lots of bending.

It’s important to know that PD may not be the best for everyone. There could be physical limitations that would rule it out, or it might not work for every lifestyle. Be sure to talk to your nephrologist to see if you’re a candidate for PD.

In addition to your continuous cycling machine, there are several supplies you will need to perform APD at home:

• Dialysate solution that arrives in stackable boxes
• Cleaning supplies including masks, hand sanitizer, bleach wipes, and machine-specific cleaning solutions
• Tubing that connects to/from the cycler

These supplies should be in a room that won’t get too hot or cold. You can order supplies monthly through the PatientHub. Many people find their supplies and cycler—which comes on a rolling cart—fit in a large closet.

APD may be the right dialysis option for you, but you may also consider home hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) as well. Home hemodialysis uses an artificial kidney to filter your blood, the same way dialysis is done in centers. CAPD is another form of PD that uses your peritoneum to filter blood. The main difference is that CAPD doesn’t use a cycler and is instead done manually throughout your day. People using APD may switch to CAPD while travelling to avoid needing a cycler, then return to APD when they get home.

Automated peritoneal dialysis is a great option for people with busy lifestyles who may want or need to dialyze in the comfort of their home. If you’re interested in APD, be sure to consult with your nephrologist and care team to discuss all the dialysis options available to you. No matter what treatment you choose, Fresenius Kidney Care is here to support your journey and help you thrive.