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Hemodialysis and peritoneal dialysis

Hemodialysis is a treatment for kidney failure that removes the blood from the body so it can be filtered through a dialzyer (artificial kidney) and then returned to the body. The blood is removed from and returned to the body through an access — either a vascular access, such as an arteriovenous (AV) fistula or AV graft, or in an emergency through a catheter. The blood is filtered many times during a four-hour treatment to remove wastes and extra fluid. Hemodialysis can be performed in a dialysis center or at home. There are several hemodialysis choices including: in-center hemodialysis, in-center self care hemodialysis, in-center nocturnal hemodialysis, traditional home hemodialysis and short daily home hemodialysis (done five to six times per week). In-center self care, in-center nocturnal hemodialysis and the home hemodialysis options may not be available in some areas throughout the United States.

Peritoneal dialysis (PD) removes wastes and extra fluid; however, it is performed within the body. The peritoneal cavity in the abdomen holds dialysis solution called dialysate, and the peritoneum, the membrane around the cavity, acts as a filter. A PD catheter, which is a small, flexible tube, is placed in the abdomen so the peritoneal cavity can be filled with dialysate. Waste passes through the peritoneum into the dialysate, which is then drained and replaced after an amount of time prescribed by the doctor. PD is performed at home, but can also be performed at work or in any other clean environment. The types of PD include: automated peritoneal dialysis (APD), which consists of continuous cycling peritoneal dialysis (CCPD) performed with a machine called a cycler, and continuous ambulatory peritoneal dialysis (CAPD), which is performed manually. PD is a dialysis option wherever home dialysis is offered.

Health and lifestyle benefits of each dialysis option

Peritoneal Dialysis (PD)

• This needle-free dialysis treatment uses the inner lining of the abdomen to clean your blood.
• You can do the flexible treatments at home, work or while on vacation.
• Peritoneal dialysis may help preserve your remaining kidney function.

Home Hemodialysis (HHD)

• You can dialyze on your schedule — up to six times per week.
• May allow for better blood pressure control, shorter recovery time after treatments and higher energy levels.
• May let you have fewer diet restrictions, better fluid control and possibly take fewer medications.

In-Center Hemodialysis

• Receive your care in a dialysis center.
• Your treatments will be provided by professional caregivers.
• Enjoy the camaraderie of fellow patients.

In-Center Nocturnal Hemodialysis

• Typical treatments are three, six- to eight-hour dialysis sessions a week at night while you sleep.
• This slow, gentle treatment can help improve your appetite and energy level.
• The treatment schedule can help free up your days for your job or personal activities.

In-Center Self Care Hemodialysis

• Administer your own treatments without the need to have a machine in your home.
• Your healthcare team is there to help you when you need assistance.
• You can choose the tasks you want to perform on your own.

Summary

Many dialysis patients may not be aware they have choices when it comes to their dialysis treatment. Sometimes patients on one modality switch to another modality as their health or lifestyle needs change. Talk to your doctor to find out which treatment may be right for you.

External links

• 
  Nephrology Dialysis Transplantation – Oxford Journal
• 
  The Journal of the American Medical Association – JAMA
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  Nephrology Dialysis Transplantation – Oxford Journal