Body Image Issues and Peritoneal Dialysis
People who treat their end stage renal disease (ESRD) with peritoneal dialysis (PD) must learn to adjust to a new reality. They may prefer this home dialysis treatment option because it gives them more freedom, a more flexible diet, fewer trips to a dialysis center and a therapy that works similar to how their kidneys did. Although the benefits of PD are abundant, feelings of insecurity can be present when making this shift in lifestyle. One of the major challenges you may face are issues with your body image. A permanent catheter and weight gain, skin problems and sometimes hair changes may be part of the transition to PD. But there are ways to handle these changes and feel good about your body image.
Weight gain and peritoneal dialysis
PD dialysis solution contains dextrose (sugar) to help you lose excess fluid. It comes in three concentrations: 1.5, 2.5 and 4.25 percent dextrose. Because some of the dextrose will move from the dialysis solution into your blood stream, you receive extra calories not included in your diet. This could cause you to gain weight, especially if you use the dialysis solution with the higher dextrose concentration. If you avoid salt and stick to your recommended daily fluid intake you should be able to use the dialysis solution with a lower dextrose concentration, reduce the amount of extra calories and keep your peritoneal membrane healthier in the process. Talk to your renal dietitian about your eating plan and the amount of calories you should consume. Making time for exercise is another way to help limit weight gain, promote heart health and feel good about your body overall. However, it is important that you ask what types of exercises your doctor or nurse recommends before you start any physical activity.
Bloating from the dialysis solution is common when you’re on PD. Patients who need to carry fluid in their abdomen during the day (called a long dwell) will notice a bulge and may have an uncomfortable feeling of fullness. This problem will be greater in people who need to remove a lot of fluid by using higher concentration of dextrose solutions. Controlling your fluid intake will help reduce the amount of fluid you need to lose and leave you less full while you are dialyzing. In many cases, the dialysis prescription can be adjusted if bloating and fullness remain a problem.
PD catheter and body image
A catheter, which is necessary for performing PD, will be placed in your abdomen. The part of the catheter tubing that exits your body is usually 5-6 inches long and should be held in place with a PD belt or by other means to avoid trauma to the exit site. In general, your PD catheter should not interfere with most forms of exercise or sexual activity. Although you may feel self-conscious at first, you are likely to get used to the catheter and appreciate that it’s now your lifeline to a better quality of life.
Skin problems, hair changes and peritoneal dialysis
When kidneys aren’t working properly, waste products build up in the body. This can cause your skin tone to change. If you have a light complexion, you may see that your skin turns to a grayish or yellowish color. When your complexion is dark, you may find that your skin tone appears darker. Because PD is a continuous therapy, working more like a regular kidney, your skin tone may not change at all or it may return to its original tone after you begin PD treatments. In the meantime, make-up products can correct skin tone if you need a quick solution.
Itchy, dry skin is another side effect of kidney failure. When picking out soap, avoid using products that are high in alcohol or heavily scented. Try a moisturizing soap for sensitive skin instead. Moisturizing creams that are high in water content are typically a better choice than regular body lotions. Ask your doctor or pharmacist which dry skin treatments they recommend.
When you first begin any form of dialysis, you may find that your hair thins out. Usually this is temporary, lasting just a few months. In the meantime, visit with a professional hair stylist who can recommend styling tips that make thinning hair less noticeable. A fresh hairstyle may help you feel more confident with your appearance.
Ways to improve body image
Changes in your body can be difficult to handle at first, especially during romantic moments, around swimsuit season or when dressing up for a special event. Although you cannot change the fact that you need dialysis, you can alter how you think about your situation. By focusing on how PD is improving your quality of life — you are more independent, can eat a less restrictive diet, feel better and have more energy — you’ll be able to think positively about your treatments. Talking to your partner, friends and family about how you feel can also help ease the stress of PD and related body image issues.
You may want to find an online or local support group to connect with other PD patients who are going through similar experiences. Hearing others share their stories about intimacy, grooming habits, eating plans and daily living will likely provide insights to how you too can cope with body changes as a PD patient. The DaVita.com Forums has a sub-forum specifically for home dialysis patients with many active participants.
Summary
Although there are many body changes that you may have to deal with while on peritoneal dialysis, focusing on the positive—that PD is prolonging your life—can help you cope with image issues. There are steps you can take to manage or minimize the changes and the way you see yourself. Talking to other PD patients may prove valuable. Your healthcare team is also available to answer your questions, provide support and look into resources that can help you improve your overall quality of life on PD.
