Hemodialysis vs Peritoneal Dialysis: Which is Right for You?

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According to the National Institute of Diabetes and Digestive and Kidney Diseases, about 14% of Americans have chronic kidney disease (CKD). Many of those people benefit from a procedure called dialysis. Dialysis is a treatment used to filter waste products from the blood when the kidneys aren’t functioning properly. Because there are two types of dialysis, you should have a conversation with your doctor about hemodialysis vs peritoneal dialysis to find out which is best for you.

What is Hemodialysis?

Hemodialysis is a type of dialysis. In hemodialysis, a machine with a special filter cleans the blood. This machine is known as an artificial kidney or dialyzer. 

During hemodialysis, the patient’s blood flows from a dialysis access point (usually in the arm) into the dialyzer. The machine filters the blood through a membrane. The waste products in the blood pass through the membrane and are washed away using a fluid called dialysate. The waste products are discarded and the cleansed blood is then returned to the body.

Patients getting hemodialysis usually need treatments three times a week. Each treatment takes around four hours. While this may be inconvenient, many patients with low kidney function benefit from hemodialysis. Home hemodialysis is also an option for some patients.

What is Peritoneal Dialysis?

Peritoneal dialysis is another type of dialysis that removes waste products from the blood when your kidneys are not functioning properly. The biggest difference in hemodialysis vs peritoneal dialysis is that hemodialysis requires an artificial kidney machine to filter blood while peritoneal dialysis does not. Rather than using a machine, peritoneal dialysis uses the lining on the inside of the belly as a natural filter for blood.

During peritoneal dialysis, the dialysate flows through a catheter into part of the abdomen. The peritoneum, which is the lining of your abdomen, acts as a natural filter and removes the waste products from your blood. After a set “dwelling” time, the fluid containing the filtered waste products flows out through the catheter so it can be safely discarded.

This type of dialysis is a good option for patients that meet certain health requirements and want fewer restrictions than they’d have with hemodialysis. However, this type of dialysis is not ideal for all patients. There are two types of peritoneal dialysis: continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis

Continuous Ambulatory Peritoneal Dialysis (CAPD)

With continuous ambulatory peritoneal dialysis (CAPD), the abdomen is filled with dialysate. The patient lets it stay in the abdomen for a prescribed dwell time before draining the fluid. Gravity moves the fluid through the catheter without machine assistance. 

According to the National Kidney Foundation, patients need three to five exchanges during the day with CAPD. They’ll also need an exchange with a longer dwell time while they sleep. Exchanges can be done pretty much anywhere that is clean and sanitized. Patients can continue their activities while the dialysate dwells in the abdomen.

Automated Peritoneal Dialysis

Automated peritoneal dialysis is also known as continuous cycling peritoneal dialysis (CCPD). This type of dialysis uses a machine that cycles through multiple exchanges at night while you sleep. The machine fills your abdomen with dialysate and allows it to dwell there for a while before draining into a sterile bag. In the morning, you empty the bag.

If you are using automated peritoneal dialysis, you must remain attached to the machine for around 10-12 hours each night. However, you do not need to connect to the machine during the day because you start each morning with a dwell time that lasts for the entire day.

Hemodialysis vs Peritoneal Dialysis

So which treatment is right for you when comparing hemodialysis vs peritoneal dialysis? Peritoneal dialysis offers continuous filtration and does not require as much disruption to your daily activities. However, hemodialysis is ideal for patients with less kidney function. Peritoneal dialysis is not a good option for obese patients or people who have abdominal scarring. Hemodialysis may be preferred by patients who want healthcare professionals to handle more of their treatments because peritoneal dialysis requires patient training and dedication.

Only you and your doctor can make the decision about which type of dialysis is best for you. Factors that will influence your treatment options include:

  • Your kidney function
  • Your overall health
  • What you’re home situation is
  • Your lifestyle
  • Your personal preferences
  • Your ability to perform the steps necessary for each type of dialysis

At Durham Nephrology, we provide comprehensive care to patients in Durham and Oxford, NC with kidney disease and high blood pressure. Our team is experienced in providing treatment with hemodialysis and peritoneal dialysis. If you have questions about hemodialysis vs peritoneal dialysis, call us at  919-477-3005 to talk to a staff member and make an appointment

When you visit our offices, you can be confident that we are taking the necessary precautions to protect the health of our patients as well as our staff. We are following all guidelines for sanitization, social distancing, and face coverings.


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