Peritoneal dialysis is a method of replacing kidney function when, as a result of disease, the kidneys have lost more than 80-85% of their filtering capacity. Life expectancy after starting peritoneal dialysis is the same as with hemodialysis treatment. There are countries in the world where 60% of patients with kidney failure are treated with peritoneal dialysis, while the remaining 40% are treated with hemodialysis and kidney transplantation. Worldwide, around 300 ,000 people are on peritoneal dialysis. In this method, special solutions are introduced into the abdominal cavity, into the space between the two peritoneal membranes that separate the organs. This allows excess fluids and waste toxic products to be removed from the body. The solutions remain in the body for several hours, and this is repeated 3-4 times a day. In this way, cleansing through peritoneal dialysis takes place 24 hours a day, 7 days a week —just as the patient's own kidneys would work.

The hemodialysis process is carried out 3 times a week for 4 hours each session and causes major fluctuations in the body. Fluid and electrolyte balance shift. Serious adaptive processes occur in the cardiovascular system to maintain adequate blood pressure. In some countries, hemodialysis is the preferred method of choice. In many other countries, peritoneal dialysis is preferred instead. Each person's specific health condition determines the choice of one method over the other. The patient should make their own personal choice after thorough information and consultation.

When and why is peritoneal dialysis preferred?

This question depends on the experience and qualifications of the physicians involved. Advantages of the method are found in diabetics, patients with hypertension, patients with severe cardiovascular failure, vasculitis, and blood disorders. An inability to construct vascular access limits the possibility of starting hemodialysis. Young children, elderly patients, and critically ill patients are also in the group that would have difficulty tolerating hemodialysis sessions lasting hours at a time several days a week. Not being dependent on a hospital setting, dialysis staff, and equipment provides a better quality of life. Peritoneal dialysis is often chosen by patients of working age with significant commitments and frequent travel, due to the ability to perform the procedure independently.Training is provided only by a qualified team of doctors and nurses trained in peritoneal dialysis. Patients relatively quickly and easily learn to carry out the procedure themselves.

Advantages of peritoneal dialysis:

1. Preserves residual kidney function
2. No need to construct vascular access via a fistula or catheter
3. Patient mobility, ease of travel, independence from dialysis equipment
4. The patient carries out the treatment themselves
5. Home-based therapy that supports the patient's personal independence
6. Lower costs compared to hemodialysis
7. Much lower risk of transmitting dangerous viral infections
8. Patients on peritoneal dialysis have greater freedom regarding fluid intake.
9. Dietary recommendations are also less restrictive
10. Higher quality of life and better social adaptation are achieved

Disadvantages of peritoneal dialysis:

1. Risk of infection at the peritoneal exit site
2. Risk of weight gain, glucose burden, and impaired fat metabolism
3. Protein loss
4. Moderately limited ultrafiltration
5. Moderately limited weekly creatinine clearance

Peritoneal dialysis is not advisable in cases of:

1. Active infections
2. Defects and post-surgical changes to the abdominal wall
3. Poor patient hygiene