Slide show: A step-by-step look at peritoneal dialysis

Dialysis is an artificial way to remove harmful waste and excess salt and fluid from your blood when your kidneys can no longer do so on their own. Peritoneal dialysis is one type of dialysis.

With peritoneal dialysis, the network of tiny blood vessels in your abdomen (peritoneal cavity) is used to filter your blood. Peritoneal dialysis can be done manually throughout the day or with a machine at night. Some people use a combination of both methods.

Here you'll see automated peritoneal dialysis. With this type of peritoneal dialysis, you must be attached to the dialysis machine for 10 to 12 hours at night. The trade-off is greater flexibility during the day.

Before you start peritoneal dialysis, a surgeon places a plastic tube (catheter) into your abdomen. Your doctor will probably recommend waiting at least a month before starting treatment to give the area time to heal.

The peritoneal catheter will exit your abdomen a few inches from your navel (A). You normally cover the catheter with a sterile dressing (B).

Before each nightly treatment session, you place a cassette into a machine called an automated cycler. The cassette contains several tubes that connect to bags of dialysis solution inside the cycler and also to a sterile drainage bag.

While you rest or sleep, the cycler fills your abdomen with dialysis solution, allows the solution to dwell there, and then drains the solution to a sterile drainage bag you empty in the morning.

After loading the tubing cassette and dialysis solution, you wash your hands, cover your mouth and nose with a mask, and put on gloves to avoid contaminating the peritoneal dialysis catheter or tubing. Then you connect the catheter to the tubing that leads to the cycler.

When you're ready to begin your treatment, get into bed. If you're not ready to sleep, you can read or watch television while the first round of dialysis fluid enters your body.

You can sleep in your normal position, as long as there's enough slack in the tubing between the peritoneal dialysis catheter and dialysis machine (see arrow). Don't worry about moving during the night. An alarm built into the dialysis machine will alert you if there's a problem, such as kinked tubing.

If you wake up in the morning before your treatment is complete, you can sit in a chair beside your bed until the last batch of dialysis fluid leaves your body.

When your treatment is complete, you disconnect the peritoneal dialysis catheter from the dialysis machine. As before, you wash your hands and wear a mask and gloves to keep bacteria away from the opening of the catheter.

Once the catheter is disconnected from the dialysis machine, you place a sterile cap on the end of the catheter to help prevent infection. After you empty the drainage bag containing used dialysis solution, you're free to go about your usual activities until your next treatment session.