The access required for peritoneal dialysis is different from the access required for hemodialysis. In order for you to do peritoneal dialysis, the dialysis fluid (also called dialysate) must be able to get to the inside of your abdominal cavity. The dialysis solution needs to be able to travel from the sterile plastic solution bag, though the tubing, and into your abdomen without touching any germs. This is done with a flexible, plastic tube called a Peritoneal Dialysis (PD) catheter. The PD catheter is surgically placed in your lower abdomen by a surgeon.
The bottom part of the catheter stays inside your body in the abdomen, also called the peritoneal cavity. There are small holes in the bottom of the catheter that allow the dialysis solution to flow into your abdomen quickly.
The middle part of the catheter “tunnels” through the fat that lies under your skin. Along the middle portion of the catheter are one or two fuzzy cuffs. When the catheter is placed into the abdominal cavity, the cuffs will lie just outside the abdominal cavity in the fatty tissue. Your tissue heals and grows around and into the cuffs. The cuffs, made of fuzzy polyester material called Dacron, protect you from infection and leaking of the dialysis solution. The path of the catheter under the skin is called the catheter tunnel. The place where the catheter comes out of your skin is called the exit site.
The top portion of the catheter stays outside of your body; about two to four inches of the catheter is left outside the exit site. A special connector will attach to the end of the catheter which will allow you to hook your catheter to the dialysis tubing when you are completing an exchange. Between exchanges, the catheter connector end is closed off with a special germ-free cap.
Remember, the reason you need a peritoneal catheter is to allow the dialysis solution to flow into and out of the peritoneal cavity. When the dialysis solution is in the peritoneal cavity, it will remove extra fluid and waste products from the body. Ideally, the catheter needs to be placed two to three weeks before starting treatment. If you experience any problems with your PD catheter, you should follow up with your healthcare team as soon as possible.