Automated peritoneal dialysis (APD) is a home dialysis treatment in which a machine, called a cycler, uses the lining of your abdomen to clean your blood while you sleep. It leaves your days largely free of treatment.
Kidney failure (end-stage kidney disease) where your kidneys can no longer remove enough waste and fluid, and in some cases severe acute kidney injury that needs temporary dialysis. APD is chosen when a home-based, overnight treatment suits your health, home setup and daily routine.
Infection of the catheter site or of the abdominal lining (peritonitis), catheter blockage or leakage, and fluid or weight changes. Risks are lowered by careful hygiene, thorough training and regular follow-up with an experienced PD team.
Blood tests and a review of your kidney function, a short procedure to place a soft catheter in your abdomen (usually healed for about two weeks before first use), and PD training for you and, if you wish, a caregiver.
Regular clinic visits, especially in the first weeks, then ongoing checks of how well your dialysis is working, your fluid balance, your catheter site and your remaining kidney function. Your nephrologist sets the schedule for you.
APD is one of the two main types of peritoneal dialysis (PD). The other is CAPD, where you do the exchanges by hand several times a day. With APD, a programmable cycler does the exchanges for you, usually across 8β10 hours at night. Your nephrologist sets the number of cycles and the fluid volumes based on your body size and how much dialysis you need.
Because a machine can run more frequent, shorter exchanges than you would manage by hand, some people dialyze more effectively on APD than on CAPD. This includes „fast transporters”, whose peritoneum absorbs dialysis fluid quickly. A soft catheter is placed in your abdomen in advance, and that catheter is what you connect to the cycler each night.
No single symptom means βstart APDβ. The decision is always made with your nephrologist, based on blood tests (such as eGFR and creatinine) and how you feel. When kidneys can no longer clear waste and fluid, people often notice:
Conditions linked to APD
APD is used when these kidney conditions have progressed to the point where dialysis is needed:
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If some of these symptoms sound familiar, try not to worry. They have many possible causes, and a simple blood test (including creatinine and eGFR) and a urine test can show how your kidneys are doing. Many people find that getting clear answers is the most reassuring step. And if your kidney function is lower than expected, there are well-established treatments and options, including home dialysis, and a team to guide you through them. A nephrologist can look at your results, explain what they mean and help you decide whether APD, another treatment or simply regular monitoring is right for you.
Each night, a typical APD session looks like this:
The cycler has built-in alarms, for example for a slow drain, so you are alerted if something needs attention.
APD is designed to fit dialysis around your life rather than the other way round. Many people value the following:
APD has risks and trade-offs to discuss with your care team. The information below comes from this treatmentβs data.
Infection of the catheter site or abdominal lining, catheter problems, and fluid or weight changes. Risks are minimised by careful hygiene, thorough training and an experienced PD team.
Common risks and side effects
Who it may not suit: These are general cautions, not a personal verdict. A qualified clinician must assess your full medical picture before recommending or delaying treatment. APD may be less suitable if you have extensive abdominal surgery or scarring, certain hernias or abdominal wall problems, or if safe home set-up and clean technique are not possible without support.
Serious complications are less common, but it helps to know what to look for so you can act early.
New or severe symptoms require prompt medical advice. Do not wait for a routine appointment if you feel seriously unwell.
Starting APD is less a „recovery” than a gradual adjustment. After catheter placement, the wound needs time to heal. The catheter can generally be used after about two weeks, and your team will tell you when to start. Training follows, usually over a few days, and your PD nurse stays closely involved in the first weeks.
Over the following weeks, most people find the nightly routine becomes familiar. Helpful habits include:
Everyone adapts at a different pace. If something feels hard, tell your PD nurse. Adjusting your prescription or your routine often makes a real difference. Treatments can also change over time, so you can discuss switching to CAPD, hemodialysis or a kidney transplant if your needs change.
Specialists linked to this treatment in the KidneyGlobal directory. Review credentials and confirm availability directly before booking.
Verified kidney centres linked to this treatment in the KidneyGlobal directory.
Once your catheter has healed, connecting to the cycler and the nightly cycles are not usually painful. Some people feel fullness or mild cramping while the fluid fills, which often eases with time. Tell your care team if you have ongoing or worsening pain, as it can be a sign of a problem such as infection.
Often yes. Because the treatment runs overnight, many people keep working or studying during the day, and APD is widely used for children for this reason. Travelling takes planning, because your clinic needs to arrange supplies at your destination, so tell your team well in advance.
Both use your abdominal lining to clean your blood. With CAPD, you do manual exchanges several times during the day. With APD, a machine does them overnight while you sleep. Neither is better for everyone, and your nephrologist will help you choose based on your health and lifestyle.
The most important sign is cloudy drained fluid. Others include abdominal pain, fever, nausea, or redness and discharge around the catheter. Contact your PD team the same day if you notice any of these.
No. APD replaces part of the work your kidneys can no longer do, but it is not a cure. Some people stay on dialysis long term, some move to a kidney transplant, and in acute kidney injury some people recover enough to stop. Your nephrologist can tell you what to expect in your case.
