Peritoneal Dialysis Systems
APD cyclers and CAPD supplies — home-based renal replacement therapy that returns patients to daily life.
Hospital-grade renal replacement therapy — without the hospital. For the patient who cannot come to the machine three times a week, the machine must come to the patient.
Peritoneal dialysis (PD) uses the peritoneal membrane as a natural semi-permeable filter — dialysate is infused into the abdominal cavity through a permanent Tenckhoff catheter, solutes and excess fluid diffuse across the peritoneum during a dwell period, and the dialysate is then drained. Automated PD (APD) cyclers — Fresenius Medical Care's Sleep•Safe Harmony and Baxter International's HomeChoice Claria — perform 8–10 overnight exchanges automatically while the patient sleeps, requiring only connection and disconnection. Continuous ambulatory PD (CAPD) requires no machine — 4 manual exchanges per day, each taking 20–30 minutes, using gravity and a purpose-made transfer set. Jos•Hansen supplies APD cyclers, CAPD transfer sets, Tenckhoff catheters, PD dialysate solution bags (1.36%, 2.27% and 3.86% glucose) and provides the nurse training and programme infrastructure to establish functioning PD programmes in East African hospitals and home therapy settings.
Overnight APD — dialysis that does not interrupt daily life
HD requires 4 hours at a clinic three times per week — preventing employment, school attendance and normal daily routines. APD is performed overnight at home: the patient connects at bedtime, the cycler performs 8–12 exchanges while they sleep, and they disconnect in the morning. Fresenius Sleep•Safe Harmony and Baxter HomeChoice Claria deliver automated overnight therapy with remote monitoring — no clinic attendance for routine sessions.
Haemodynamic stability for cardiovascular-compromised patients
Intradialytic hypotension affects 20–30% of HD treatments — because HD removes 2–4 litres of fluid rapidly over 4 hours. Peritoneal dialysis removes fluid continuously and slowly, matching the rate at which it can be physiologically mobilised. PD is significantly better tolerated by patients with cardiac dysfunction or haemodynamic fragility — the comorbidities most common in Africa's hypertension- and diabetes-driven ESRD population.
Residual renal function preserved longer on PD
Residual renal function declines faster in HD patients than in PD patients — attributed to recurrent hypotensive episodes and the inflammatory burden of the extracorporeal circuit. Each 1 mL/min of preserved residual GFR reduces mortality risk and improves solute clearance. PD is the recommended first modality for incident ESRD patients with remaining native kidney function.
Building a PD programme — not just supplying cyclers.
PD is clinically appropriate for 50%+ of incident ESRD patients yet represents fewer than 10% of African dialysis treatments — because programme infrastructure is missing: trained PD nurses, Tenckhoff catheter insertion capability and a dialysate supply chain. Jos•Hansen establishes all of it — catheter insertion training, nurse education, in-country buffer stock and patient home training protocols.
Tenckhoff catheter access — the surgical foundation of PD.
Every PD patient requires a permanent Tenckhoff catheter for dialysate exchange. Catheter complications — infection, malposition, exit site problems — are the leading cause of PD technique failure. Jos•Hansen trains hospital surgical teams on insertion technique, supplies instruments and implements exit site care protocols targeting 85%+ catheter survival at 12 months.
Dialysate supply — in-country stock that prevents treatment interruptions.
Each CAPD patient requires 8 litres of dialysate per day; APD patients 10–15 litres per night. Jos•Hansen manages importation and in-country distribution of Fresenius and Baxter dialysate solutions — 1.36%, 2.27% and 3.86% glucose plus icodextrin — with buffer stock in Nairobi and Mombasa preventing the supply gaps that have historically forced African PD patients off therapy.
Technical specifications.
APD cyclers
Fresenius Sleep•Safe Harmony · Baxter HomeChoice Claria
APD therapy types
CAPD · APD (CCPD) · NIPD · Tidal PD
Cycler fill volume
500–3,000 mL per exchange · programmable
Session duration
8–10 hours overnight APD
Dialysate solutions
1.36% · 2.27% · 3.86% glucose · icodextrin (Extraneal)
Catheter types
Tenckhoff straight · coiled · swan-neck · CE Marked · FDA cleared
Of incident ESRD patients clinically suitable for peritoneal dialysis — the majority who are not offered PD in African settings due to programme infrastructure gaps, not clinical criteria
HD treatments complicated by intradialytic hypotension — versus near-zero with continuous peritoneal dialysis, making PD significantly safer for cardiovascular-compromised patients
Overnight APD session duration — dialysis delivered while the patient sleeps, preserving full daytime activity, employment and school attendance
Why Peritoneal.
Overnight therapy — normal daily life
APD performed during sleep eliminates the 3×/week hospital attendance of HD — patients can work, study and live without scheduling around dialysis clinic hours.
Haemodynamic stability
Continuous slow fluid removal avoids the cardiovascular stress of rapid HD ultrafiltration — significantly reducing hypotension events in cardiac-compromised patients.
Residual renal function preserved
PD patients preserve residual GFR longer than equivalent HD patients — each 1 mL/min of residual function reduces mortality risk and improves solute clearance.
Full PD programme infrastructure
Jos•Hansen establishes catheter insertion training, nurse PD education, dialysate supply chain and patient home training — the complete programme, not just cyclers delivered.
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