Is Peritoneal Dialysis Performed Daily?
Yes, peritoneal dialysis is performed daily—in fact, it operates continuously 24 hours per day, 7 days per week, providing uninterrupted renal replacement therapy throughout the entire week. 1
How PD Operates on a Daily Basis
Peritoneal dialysis differs fundamentally from hemodialysis by providing continuous therapy rather than intermittent sessions. The specific daily schedule depends on the modality chosen:
Continuous Ambulatory Peritoneal Dialysis (CAPD)
- Operates 24/7 with fluid continuously dwelling in the peritoneal cavity 1
- Patients typically perform 4-5 manual exchanges throughout each day, every day 2, 3
- Each exchange involves draining old dialysate and infusing fresh solution, with fluid remaining in the abdomen between exchanges 3
- The dialysate is never completely removed except during exchanges—the peritoneal cavity always contains fluid performing dialysis 1
Automated Peritoneal Dialysis (APD)
- Also runs 24 hours daily but concentrates exchanges during nighttime hours 1
- A cycling machine performs multiple exchanges overnight, typically running 9-10 hours per night 2, 1
- Approximately 85% of APD patients require one or more daytime dwells in addition to nighttime cycling to achieve adequate clearance 1
- The machine operates every single night—this is not an every-other-day therapy 4
Nightly Intermittent Peritoneal Dialysis (NIPD)
- Reserved for specific populations (high/rapid transporters with significant residual kidney function) 2, 1
- Performs exchanges only during nighttime hours without daytime dwells 1
- Still performed nightly, not intermittently throughout the week 2
Why Daily/Continuous Treatment Is Essential
The weekly clearance targets (Kt/V ≥2.0) are calculated based on this continuous 168-hour-per-week treatment schedule 1. Unlike hemodialysis, which delivers therapy in 3-4 sessions per week, PD achieves adequate solute clearance through constant, ongoing dialysis 1.
Patients cannot skip days of PD treatment. The prescription is designed around daily exchanges, and missing treatments would result in inadequate dialysis, uremic symptoms, and potentially life-threatening complications 2.
Common Pitfall to Avoid
Do not confuse the flexibility in timing of exchanges (morning vs. evening for CAPD, or which hours the cycler runs for APD) with the ability to skip days. PD must be performed every single day without exception to maintain adequate solute clearance and fluid removal 2, 1.