[StudentNurseBean]

Hi there..
I was curious if someone can clarify this for me. Peritoneal dialysis has a dwell time of 4-6 hours, correct? My notes from class say 20-30 minutes, but I keep seeing everywhere that it is 4-6 hours. What is a safe amount of time to allow the dialysate to sit in the peritoneum before equilibration takes place? Thanks for your help

[Future_Nurse_Natalie]

Dwell time is 4-6 hours from my understanding. The 20-30 mins is the amount of time it takes for the dialysate solution to return from the peritoneum. It takes 10 mins to go in and 20-30 mins to come back out. Meanwhile, it stays in the peritoneum for 4-6 hours. Hope this helps (and hopefully I am correct )

[Daytonite]

From my understanding and limited experience with this, as we had several patients who were getting CCPD (Continuous Cycling Peritoneal Dialysis) in the last nursing home where I worked, the dwell times were determined by the doctor and occurred overnight. They lasted about an hour or an hour and a half in order to be able to be completed throughout the night so the patients could be up and about during the day. I have heard, however, that the very last dwell of dialysate will sometimes be ordered to be left in for as long as 6 or 8 hours (the entire day) while the patient is up and about. The reason you wouldn't want to leave the dialysate in for very long hours is because of the risk of the patient developing hyperglycemia, so the patient would have to be evaluated for the posibility of this happening before it would be ordered to be done. The whole issue of how long dialysate is going to be allowed to dwell in the abdomen also has to do with whether the patient is receiving dialysis throughout the 24 hour day or only at night. The first article I've linked you to below discusses this.

http://kidney.niddk.nih.gov/kudiseases/pubs/peritoneal/ - Treatment Methods for Kidney Failure: Peritoneal Dialysis

http://kidney.niddk.nih.gov/kudiseases/pubs/peritonealdose/ - Peritoneal Dialysis Dose and Adequacy

http://www.mayoclinic.com/health/peritoneal-dialysis/DA00079

http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/dialysis_kidney.jsp - Kidney Dialysis

[StudentNurseBean]

Interesting. My professors notes are incorrect. Not only is her dwell time wrong, but she also said one run through includes the "dwell time". However, according to these websites it includes only the fill and run out as one run. I'm gathering from this that it is 4-6 hours with about 6 runs throughout day & night.

[Daytonite]

Before you pronounce your instructor as being wrong, I would talk to some of your fellow students and see what they have in their notes. Then, privately discuss this question of dwell times with your instructor and bring up at that time what you found out. I'm not sure you've understood everything you've read because I came away from reading it with quite a different perspective.

[StudentNurseBean]

Hi Daytonite..

Thanks for all of your input and information that you've provided.

Actually, we all have the same notes. They came directly off of blackboard and they're printed. I contacted her about it and she emailed me back and said she did actually make a mistake and thanked me. Our notes are supposed to be for CAPD and the dwell time is anywhere from 4-6 hours with 3-4 exchanges per day depending on the Drs order and also, one overnight exchange. She wont be testing us on this because her information was wrong and so she went ahead and posted the correct information on blackboard. I hate to approach professor's if I've read or heard that their information may be incorrect. I almost feel as if I am stepping on their toes because they know more than I do, being that they are a seasoned RN. In this case, it turned out good

[saskenn]

Hello,
I've been working in Dialysis for years. PD patients empty their bags every 4-6 hours. That's the reason they have so much more flexibility than hemodialysis patients.