What is the proper way to dispose PD fluid?

Dear Doctor,
My father has just started peritoneal dialysis (PD) and we are all still learning the procedures and how it all works. It is our understanding that the ‘waste’ from PD should be treated as urine, and disposed of in the toilet. What is the proper way to dispose PD fluid?

Waste fluid that a peritoneal dialysis (PD) patient takes out after their dwell time should be treated like other body fluids and disposed of in the toilet. The PD fluid waste that comes out isn’t urine exactly but very similar because like urine, it contains many of the toxins your kidneys would normally filter out. For this reason, it can actually damage and erode any metal part of the drain in either a sink or bathtub, thus, patients are highly advised against draining any fluid waste in any other means than a toilet.

Wherever it is disposed of, it will lead to erosion if metal is present. Draining the PD fluid in any other location, for example, the kitchen sick, can cause damaged and there is no way to fix this damage, only to replace the drain which could be expensive. The empty bags the PD solution comes in should be sealed in a plastic bag before being placed in the household garbage. This will prevent residue from the drain bag from spilling. According to a survey published in Peritoneal Dialysis International, patients who are at risk of HIV or hepatitis B should take extra precaution. 1Patients who are either infected with, or who are deemed at risk of developing an infection from hepatitis B or HIV, should include a method of disinfection of the emptied bags. A cupful of household bleach should be poured into the toilet and the bag drained into this. The toilet should be flushed after 5 minutes, which would allow any particles to be killed before they reach the sewage system. The emptied CAPD bags should be placed in a plastic bag to which a small quantity of bleach has also been added. Individual CAPD units should decide whether this bag could be discarded in the household garbage or returned to the unit in a red medical waste bag for disposal by the unit.

Mark H. Shapiro, MD, is a clinical nephrologist who practices in Escondido, Calif. He’s a Peritoneal Dialysis Medical Advisor to DaVita Healthcare, and is an Assistant Professor of Medicine at the University of California, San Diego. 

Reference:
1. Peritoneal Dialysis International, Vol. 11, pp. 77-75, 1991

The Dear Doctor column provides readers with an opportunity to submit kidney-related health questions to healthcare professionals. The answers are not to be construed as a diagnosis and, therefore, alterations in current health care should not occur until the patient’s physician is consulted.