Continuous ambulatory peritoneal dialysis (CAPD) is a manual, home-based dialysis that uses the lining of your abdomen as a natural filter. You swap bags of cleansing fluid yourself about three to five times a day, with no dialysis machine.
Kidney failure (end-stage kidney disease) in people who are suited to home dialysis, and advanced kidney disease with fluid overload or uraemic symptoms that medication can no longer control.
Peritonitis, exit-site infection, catheter problems and hernia. Risks are minimised by strict hand hygiene, thorough training and an experienced peritoneal dialysis team.
Blood tests, an abdominal check for hernias or scarring, planning of the catheter operation with fasting per protocol, and a training programme for you or a carer.
An early check after catheter placement, then clinic visits typically every month, routine blood tests and dialysis adequacy checks, plus daily home checks of your exit site and drained fluid.
When your kidneys can no longer clear waste and fluid on their own, dialysis takes over part of that job. CAPD is one of two main types of peritoneal dialysis (the other is automated peritoneal dialysis, APD, which uses a machine overnight). In CAPD:
It’s called „continuous” because dialysis is happening around the clock, not just during a session, which tends to keep waste levels steadier than treatment done only a few times a week.
Kidney failure often builds slowly, so early symptoms are easy to blame on stress, age or a busy life. Things you may notice or feel include:
None of these proves you need dialysis β many have other causes. But when they persist and your blood tests show very low kidney function, your nephrologist may talk with you about starting dialysis. NICE guidance says to consider it when symptoms affect daily life, when fluid or blood chemistry canβt be controlled, or at an eGFR of around 5β7 mL/min/1.73 mΒ² even without symptoms, and to make the decision together with you.
Conditions linked to CAPD CAPD is most often discussed for people living with the conditions below:
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Having some of these symptoms doesn’t mean something is seriously wrong β they are common and often have other causes. A simple blood test (creatinine and eGFR) and a urine test can show how well your kidneys are working, and many people with reduced kidney function are managed for a long time without needing dialysis. If your results are low, or you’re simply not sure what they mean, a kidney specialist can explain them in plain language and go through your options with you. You don’t have to wait for things to get worse β find a specialist on KidneyGlobal and ask whether CAPD could be right for you.
Each exchange has three steps and takes about 30β40 minutes, done four to five times over 24 hours:
Before your first exchange, a nurse trains you (and/or a family member) in hand hygiene, connecting, draining, filling and exit-site care, usually over one to two weeks.
CAPD gives many people more control over daily life than clinic-based dialysis. The main benefits are:
Benefits depend on how well CAPD suits your health and home situation. A 2004 Cochrane review found too little trial evidence to say CAPD is better or worse than haemodialysis overall, so the right choice is individual β talk it through with your nephrologist.
CAPD has risks and trade-offs to discuss with your care team. The information below comes from this treatment data.
Peritonitis, exit-site infection, catheter problems and hernia. Risks are minimised by strict hand hygiene, thorough training and an experienced peritoneal dialysis team.
Who it may not suit: CAPD can be harder with extensive abdominal scarring or previous major abdominal surgery, a large hernia that hasnβt been repaired, serious lung or heart problems, or when a clean space and the ability to do exchanges (alone or with help) arenβt available. These are general cautions, not a personal verdict. A qualified clinician must assess your full medical picture before recommending or delaying treatment.
Side effects you may notice, most of which your team can help manage:
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Complications are not the norm, but they can happen with any dialysis, and spotting them early makes a big difference. The main ones are:
Contact your PD team immediately β don’t wait for your next appointment β if you notice:
Caught early, peritonitis is usually manageable β sometimes without a hospital stay. Bring the cloudy bag with you if your team asks you to come in.
New or severe symptoms require prompt medical advice. Do not wait for a routine appointment if you feel seriously unwell.
The catheter exit site needs about 10β14 days to heal before full exchanges begin. Most people feel comfortable doing their own exchanges within one to two weeks of training. It’s normal for the routine to feel unfamiliar at first β your PD nurse stays closely involved and is a call away if something feels off.
CAPD’s daily clearance generally allows a more liberal diet than haemodialysis, with its own adjustments:
A renal dietitian can give you numbers specific to you.
Expect regular clinic visits (typically monthly), a peritoneal equilibration test (PET) to see how well your peritoneum transports waste, and routine labs that track dialysis adequacy, electrolytes and protein. CAPD can be a long-term treatment or a bridge to a kidney transplant. Some people stay on it for years; others move to haemodialysis if the membrane’s filtering ability declines. If the adjustment feels hard, you’re not alone β connecting with others through the KidneyGlobal community can help.
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.
No. Filling and draining shouldn't hurt. Some people feel fullness or bloating while the fluid is in, which most get used to. The catheter operation can be sore for a few days afterwards.
CAPD is done by hand during the day with no machine. APD uses a machine (a cycler) to do the exchanges while you sleep. Haemodialysis filters your blood outside the body through a machine, usually at a centre a few times a week, while CAPD cleans it inside your body using your own peritoneum.
Yes. Exchanges can be done at home, at work or while travelling in any clean, private space, and supplies can usually be shipped to where you're going. You'll need to plan your exchange times around your day.
Showering is usually fine once your exit site has fully healed. Swimming needs advice from your PD team, because water can carry germs to the catheter site. Always clean and dry the site afterwards.
There's no fixed limit. Some people stay on it for years. Over time the peritoneal membrane can become less effective, and your team may suggest switching to haemodialysis. If you're eligible, a kidney transplant is the other long-term option.
No. A PD nurse trains you (and a family member or carer if you wish) before you start, and your clinic stays on call for problems. Many people do their own exchanges once trained, but help at home is common, especially for children and older adults.
