Peritoneal Dialysis vs Hemodialysis

End stage kidney disease often requires that individuals undergo a transplant or dialysis in order to prolong life. Dialysis is a medical procedure that removes water and waste from the body so that it is not allowed to accumulate to toxic levels. Patients who are faced with the prospect of long-term dialysis treatment may qualify for a few different types of therapy depending on their status. When evaluating the benefits and risks of peritoneal dialysis vs hemodialysis, there are many important factors to consider.


Hemodialysis is the procedure that most people think about when they picture dialysis. This is the approach that is taken in most treatment facilities where machines are used to filter the blood. In order to transfer blood from the body to the dialyzer, a vascular access point must be established. This access point is commonly referred to as an anastomosis and it is created when a surgeon connects an artery to a vein just under the skin. When a patient goes to a clinic for treatment, large needles are used to access the anastomosis so that blood can flow from the body to the machine and then back. While this procedure is often performed in clinics, it can also be administered at a patient’s home. In either case, the process requires at least three to five treatments per week for a period of four to six hours for each treatment.

Peritoneal Dialysis

There are important risks and benefits that must be assessed when deciding between peritoneal dialysis vs hemodialysis. The peritoneal approach to filtering blood differs from hemodialysis because it does not use a machine external to the patient’s body in order to remove excess water and waste. Within the abdomen, there are many small blood vessels that are capable of filtering the blood when the particle concentration outside the vessels is higher than inside the vessels. In order to create a concentration gradient, a tube is placed through the abdominal wall and fluid is passed through the tube. This fluid is left in the abdomen for a few hours so that water and waste can leave the blood vessels and accumulate outside the vessels. The fluid is then removed from the abdomen and replaced. This process is referred to as an exchange and it can be performed in many different locations including home, work, or while traveling.

Some benefits associated with this type of dialysis include the ability to administer treatment when it is convenient, a more normal diet, fewer fluid restrictions, and a more generalized feeling of being healthy. While there are many benefits associated with this approach, patients must be willing to have a tube placed in the abdomen and must accept that the tube could become infected and result in a peritoneal scar. In general, eligibility for peritoneal dialysis vs hemodialysis requires some remaining kidney function and frequent testing. Over time, the peritoneum may become less efficient at filtration requiring a patient to switch to hemodialysis.

Hemodialysis

Hemodialysis is most often performed in dialysis facilities where patients can receive assistance from qualified professionals and be monitored during treatment. Most patients schedule three appointments each week that last four hours per visit. It is very important for patients to remain consistent in the appointment scheduling and compliance process. Prolonged gaps in dialysis treatment can lead to severe illness or even death. Many patients prefer to receive treatment in a clinic because they are able to receive help when needed and are able to interact with other patients who are struggling with the same disease. Some of the downsides of in-center hemodialysis include time limitations, more fluid restrictions, increased medication requirements, and a higher risk of adverse side effects.

Some dialysis facilities in the United States have begun offering more convenient in-clinic treatment options to help accommodate patient scheduling demands. An increasingly popular approach to treatment is the use of nocturnal hemodialysis during which patients have their blood filtered overnight while they sleep at the clinic. Patients who take advantage of this opportunity receive longer treatments, have fewer fluid restrictions and side effects, and are able to maintain their normal daily routine.

Peritoneal Dialysis vs Hemodialysis


A thorough evaluation of peritoneal dialysis vs hemodialysis, often reveals many of the same beneficial health outcomes for patients including positive fluid balance, improved blood pressure, decreases in chronic illness, higher quality of life, and a good appetite and sleep schedule. While end stage kidney disease and dialysis are often difficult for patients to accept, treatment does provide a means by which individuals can continue to enjoy life and engage in daily activities that they have become accustomed to.

2 thoughts on “Peritoneal Dialysis vs Hemodialysis

  1. Louise Whelan

    I am a Registered Nurse; however, I come to this site to compare dialysis options for my diabetic kidney disease. I was happy with this article and now am hoping I am a candidate for peritoneal dialysis.

    Thank You,
    Louise

    1. Steve Post author

      Hi Louise,

      I am very happy that the information we have published here has been helpful. As with all things medical, the information found here is no substitute for professional medical advice and we strongly encourage you to discuss your treatment options with your physician. I wish you the best with your treatment.

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