What’s the Difference Between Hemodialysis and Peritoneal Dialysis?

Image source: Medical News Today

The Difference Between Hemodialysis and Peritoneal Dialysis

​Kidney disease is a severe ailment that affects an estimated 37 million people in the United States, with millions more at risk. Kidney disease poses various health concerns and complications and, if left untreated, can be fatal. The most effective way to treat kidney failure is through dialysis. 

There are two different types of dialysis: hemodialysis and peritoneal dialysis. In this guide, we’ll explain who needs dialysis, the two types of dialysis, the differences between peritoneal dialysis vs. hemodialysis, and which dialysis type is right for you.

When Do You Need Dialysis?

To better understand the differences between hemodialysis and peritoneal dialysis, it's important to thoroughly understand what the kidneys do and why they are significant. Your kidneys are crucial to filtering waste and harmful substances out of the bloodstream. They absorb essential vitamins and nutrients, expelling everything else out of the body in the form of urine. The kidneys also regulate your body's hydration levels and assist in hormone production. 

If your kidneys fail, they allow harmful elements into the bloodstream, leading to complications with the central nervous system, diabetes, heart problems, and more. You may also experience some common symptoms of kidney failure, such as nausea, vomiting, decreased urine output, fatigue, swelling from fluid retention, and more.

If your kidneys no longer remove enough waste and fluid from your blood to keep you healthy, your doctor may recommend dialysis treatments. Dialysis is the most effective way to treat kidney disease. It's a process that allows artificial regulation of hydration, hormone production, and waste filtration. Essentially, the process conducts the kidneys' duties. Treatment is administered on average for about four hours, three times per week. Frequency depends on the severity of the disease and the patient, and patients undergoing home hemodialysis treatments may opt for longer treatments on fewer days a week. ​

What Is Hemodialysis?

Picture cred: National Institute of Diabetes and Digestive and Kidney Disease

Hemodialysis is a process that cleans the blood via a machine called a dialyzer which works as an artificial kidney. Before starting treatments, your doctor will create an exit and entry point for the blood, which is usually done by arm surgery. The blood is drawn from the access point and through IV tubes that send it into the dialyzer, which filters out the waste and retains essential nutrients. It then begins pumping the newly cleaned blood back into the body. 

This process is done either in a hospital, dialysis center, or, depending on the severity of the disease and the patient's personal situation, at home. 

If the kidney disease is caught early enough, hemodialysis may not be needed in the long term. As long as the patient maintains a strict and healthy hemodialysis diet, as instructed by the doctor, the kidneys may heal over time and the patient will see restored functionality. However, if the disease has progressed to severe levels, hemodialysis will be administered for the rest of the patient's life or until they receive a kidney transplant.

What Is Peritoneal Dialysis?

Peritoneal dialysis shares the same basic treatment principles as hemodialysis but is performed differently. Instead of using a dialyzer to clean the blood, peritoneal dialysis uses the lining of your abdomen as a filter. Treatments are done with a special cleansing fluid called dialysate that flows into your abdomen using a catheter. The catheter is usually inserted near the belly button and will require about a month to heal before starting treatments. Patients receiving peritoneal dialysis will require some education as they perform the treatments independently from their homes. 

There are two types of peritoneal dialysis; Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD). With CAPD, the dialysate is administered via the catheter into the abdomen, left for several hours to clean the blood, and then later drained. The administration and draining process takes around 30 minutes and is done between 3-5 times daily. During this time, the patient can continue their day as usual.

APD is similar to CAPD, except treatments are done with a machine while the patient sleeps. The machine connects to the patient’s catheter, fills it with dialysate, lets the cleansing fluid sit for a while, and drains it into a sterile bag which can be emptied in the morning. APD treatments usually take 10 to 12 hours and don’t require patients to be connected to the machine at any other point during the day.

While receiving peritoneal dialysis, your doctor will likely recommend different tests to measure the treatment’s efficacy. These tests help determine if any changes are needed to your treatment routines, such as increasing the number of daily exchanges or the amount of dialysate used with each treatment. 

Hemodialysis Vs. Peritoneal Dialysis: Which One Is Right for You?

Various factors play a role in which dialysis treatment you and your doctor decide is right for you. These factors often include your lifestyle, line of work, disease severity, and personal preferences. Your kidney specialist will explain the pros and cons of each type of dialysis to find what's best for you. 

Here’s a general overview of the pros and cons of each dialysis type.

Advantages of Hemodialysis

• More effective for patients with severely reduced kidney functions
• Treatments are performed and supervised by experienced healthcare professionals
• Only requires treatments three or four days a week
• Home hemodialysis is an option, and treatments can be performed while you sleep

Disadvantages of Hemodialysis

• Requires frequent visits to a hospital or dialysis center for treatments if home hemodialysis isn’t an option for you
  
• Can be disruptive to daily activities like work and limit your ability to travel
  
• Patients need to follow a strict hemodialysis diet
  
• The surgically crafted access point is at risk for infections and must be kept clean
  
• Can cause side effects like fatigue and low blood pressure
  

Advantages of Peritoneal Dialysis

• Done from the comfort of your own home 
  
• Provides continuous filtration and cleaning
  
• Less disruptive to your daily life
  
• Fewer diet restrictions than hemodialysis
  

Disadvantages of Peritoneal Dialysis

• The surgically inserted catheter can cause discomfort and is at risk of becoming infected
  
• Treatments are required daily
  
• May not be an option for patients who are overweight or have abdominal scarring
  
• Responsibility is on the patient to understand their treatments and perform their treatments correctly
  

Dialysis Treatments in Milwaukee

The most significant advantage of both hemodialysis and peritoneal dialysis is that they help patients live healthier and longer lives. At Milwaukee Nephrologists, your health and quality of life are our first priority. Our board-certified physicians are experts in their field and will work with you to develop a treatment plan that addresses your needs and fits your lifestyle.

If you or a loved one suffer from or are at risk for kidney disease, we’re here to help. Contact us today to schedule a consultation.