Patient Support Guide: What to Expect When Starting Peritoneal Dialysis

Starting peritoneal dialysis is more than a medical transition — it’s a life transition.

There’s a lot to learn, but more than that, there’s a lot to adjust to. Your routines, your sleep, your space, even how you move through your day.

We created this guide from real patient experiences — to help you feel more prepared, more supported, and less alone as you begin.

Finding Your Rhythm With Peritoneal Dialysis

In the beginning, everything can feel unfamiliar. The setup, the process, the timing — it can feel like a lot to manage.

But over time, something shifts.

What once felt clinical starts to feel personal. You begin to build a routine that works for you — your space, your schedule, your pace.

Small things make a difference: keeping your supplies organized and in one place, creating a calm environment, and setting up in a way that feels manageable night after night.

As you settle in, your rhythm doesn’t just change — it forms. What feels unfamiliar today becomes second nature, shaped by your routine, your preferences, and the support of your care team and caregiver.

“At first it felt like a process I had to follow. Now it feels like part of my life.”
— Carol, dancing in her rhythm

Your Care Team Is Your Foundation

You are not expected to do this alone.

One of the most comforting things patients share is how quickly their care team becomes part of their life — not just as medical professionals, but as steady, supportive voices you can rely on.

They’ve guided so many people through this transition. They understand the questions you might not even know how to ask yet.

And more than anything — they want to hear from you.

If something feels off, confusing, or even just unfamiliar, reach out. You’re not bothering them. You’re doing exactly what you’re supposed to do.

Over time, that connection becomes one of the strongest parts of your support system — helping you feel more confident, more informed, and more at ease in your routine at home.

“I used to hesitate before calling… now I don’t think twice. Every time I reached out, they met me with patience, kindness, and answers. That changed everything for me.”
— Mei, calling without hesitation (and usually with snacks nearby)

Creating a Clean, Safe Space

Keeping your space clean is one of the most important parts of peritoneal dialysis — and one of the biggest adjustments in the beginning.

At first, it can feel like a lot to think about. Every step, every surface, every connection – even the air! That awareness is new — and it’s normal for it to feel overwhelming.

But over time, it becomes part of your rhythm.

You start to move through your setup with more ease and confidence. What once required careful thought becomes second nature — a routine built on consistency, awareness, and care.

Creating a dedicated space, keeping supplies organized, and following the guidance from your care team all play an important role in reducing risk and helping you feel more in control.

And for many patients, having a caregiver who is equally mindful of cleanliness adds another layer of confidence and support.

“In two years on PD, I’ve never had peritonitis — and a big part of that is how careful my caregiver is about keeping everything clean. It just became part of how we do things.”
— Jeff, two years strong (with a very watchful wife/caregiver)

Sleep, Comfort, and Adjusting to the Setup

Sleep is one of the hardest adjustments for many patients starting peritoneal dialysis — and one of the most important.

The machine, the tubing, the alarms… it can take time to feel comfortable resting while connected. It’s not just about getting through the night — it’s about being able to truly sleep.

And in the beginning, that doesn’t always come easily.

One of the most common — and most disruptive — challenges patients and caregivers share is nighttime alarms caused by kinked or restricted tubing.

If this is happening to you, you’re not alone. It’s something almost everyone encounters at some point while adjusting to PD.

Positioning matters. Setup matters. And how your tubing is supported while you move or turn during sleep can make a meaningful difference.

That’s exactly why solutions like Kink Free PD™ and the PD Flow Belt™ were developed – to help reduce tension on tubing, support more natural movement, and create a setup that feels more stable and manageable through the night.

Because when sleep improves, everything else begins to feel more manageable.

“The alarms at night were exhausting — for both of us. My wife was constantly adjusting the tubing, trying to keep everything flowing, and neither of us were really sleeping. When she found Kink Free PD, it changed everything. We’re finally able to rest again.”

— Javier, sleeping through the night (together)

Movement and Confidence

It’s completely natural to feel cautious at first — especially with tubing and equipment.

You may find yourself moving more carefully, thinking through each step, adjusting how you sit, stand, or get in and out of bed.

That awareness is part of the beginning.

But over time, something shifts.

Movement becomes easier. More natural. Less something you think about — and more something you simply do.

Confidence builds gradually, as you learn what feels comfortable and what works best for your body and your routine.

And often, it’s the small things that make the biggest difference.

Tools that help keep tubing secure and out of the way — like the PD Flow Belt™ — can provide a sense of stability that allows you to move more freely and with less worry.

When everything feels supported, you don’t have to think about it as much.

You just move.

“Once I started wearing the belt, I didn’t want to take it off. It’s so comfortable, my caregiver has to remind me to change it out. It just makes everything feel easier.”
— Elena, moving with ease (and not giving it back)

Hydration and Nutrition

As you begin peritoneal dialysis, your body’s needs may shift — and learning how to support it becomes an important part of your routine.

Hydration is one of the first things you’ll learn to pay attention to. It’s not one-size-fits-all, and your needs may change over time depending on your treatment and how your body responds.

Your care team will guide you on what’s right for you — when to drink more, when to be mindful, and how to stay balanced.

Nutrition works the same way.

You may hear more about protein, potassium, and phosphorus — and how they play a role in how you feel day to day. PD can remove small amounts of protein, which means getting enough becomes especially important.

At first, it can feel like a lot to think about.

But over time, it becomes part of your rhythm — learning what fuels your body, what supports your energy, and what helps you feel your best.

And you don’t have to figure it out alone. With guidance and a little patience, it becomes more manageable than it may feel right now.

“At the beginning, I felt like I had to rethink everything I was eating and drinking. But with time — and help from my care team — it started to make sense. Now I know what my body needs.”
— Sofia, nourishing her rhythm

Monitoring and Daily Awareness

Small, consistent habits can help you feel more in control.

One of the most important is checking your exit site regularly — daily if you can, or having your caregiver take a look. Even small changes are worth noticing.

You may not always feel when something is off, which is why simply putting eyes on it becomes so important.

Regular check-ins with your care team matter too. Monthly bloodwork helps monitor your nutrient levels and make sure everything stays balanced as your body adjusts to PD.

Over time, these small moments of awareness become part of your routine — simple, steady habits that help you stay ahead of any potential issues.

“I didn’t feel anything at first, but my wife noticed a rash right away. I’m so grateful she caught it early — that kind of attention makes all the difference.”
— Marcus, grateful for a second set of eyes

You’re Allowed to Have Good Days and Hard Days

There will be days where everything feels smooth — where your routine flows and things feel manageable.

And there will be days where it doesn’t.

That’s part of this.

Adjusting to peritoneal dialysis isn’t just physical — it’s emotional and mental, too. It takes time to find your rhythm, your confidence, and your way of moving through it all.

Give yourself space for that.

You don’t have to have it all figured out today.

And you don’t have to go through it alone.

There is a whole community of patients, caregivers, and care teams walking this path — learning, adjusting, and supporting one another along the way.

You are part of that now. And we are here with you. 

“Some days I feel strong, some days I don’t. Both are part of this.”
— Daniel, showing up no matter what