TYPES OF PD 315

Daytime dwells Night-time dwell

CAPD

Night dwells

‘Wet day’ or
APD
long day dwell

Night-time dwells

TIDAL APD

Fig. 4.8 Types of PD. Reproduced with permission from Levy J, Morgan J, and Brown
E (2004). Oxford Handbook of Dialysis, 2nd edn. Oxford: Oxford University Press.

CAPD technique
Disconnect, flush-before-fill Y-systems are now the norm. The ‘connectology’
has been refined over the years to minimize peritonitis risk through touch
contamination. At the time of an exchange, the patient connects a Y-shaped
set with a sterile drain bag and a fresh dialysate bag. Patients are taught to
make this connection using a sterile technique, although various assist devices
are available to aid patients with dexterity or visual problems (e.g. UV Flash
Compact®). After the waste dialysate is drained into the empty bag, the
Y-connector is flushed (theoretically, flushing away any contaminating bac-
teria in this portion of the giving set), using a small volume of fresh dialysate.
The remaining dialysate is infused into the patient’s abdomen. (See Fig. 4.9)

Fresh dialysate

Peritoneum

Catheter
Connector
Adapter
Connecting
line*

Drainage bag
* Changed 6-monthly

Fig. 4.9 ‘Disconnect’ PD system. Reproduced with permission from Levy J,

Morgan J, Brown E (2004). Oxford Handbook of Dialysis, 2nd edn. Oxford: Oxford
University Press.