Difference between Hemodialysis and Peritoneal Dialysis

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What is Dialysis?

The kidneys are one of the major organs in the human body and perform multiple functions. They help remove waste products generated in the body through diet metabolism. The waste is excreted out of the body in the form of urine. The kidneys also remove excess salt, water, many drugs which we consume, regulate acid and potassium content in the body and help balance the body fluids. Kidneys also secrete hormones that trigger production of red blood cells in the body, regulate blood pressure. Kidneys also produce an active form of Vitamin D that is required for strong and healthy bones.

Needless to say, kidneys are prone to various ailments and conditions including kidney failure. Kidney failure may be Reversible- meaning, it can be recovered with treatment. End-stage or chronic kidney failure is one in which kidneys are no longer able to cope and dialysis and transplant are the only options

Dialysis is a treatment in which the blood of patients with kidney failure is cleaned through artificial means, either outside the body or inside the body. Combined with other medication, dialysis helps the patient of end-stage kidney failure live longer.

Types of Dialysis

There are 2 types of dialysis: Hemo and Peritoneal. In Hemodialysis, the blood is cleaned outside the body using a dialysis machine and then sent back into the body. This can be done either at a hospital or at home. In peritoneal dialysis, a special liquid is put in the abdomen. As blood passes through blood vessels in the abdominal cavity, this liquid absorbs waste from them across the peritoneal membrane (lining of our abdomen). This polluted liquid is then drained away. This procedure can be done at home. These are the major differences. Let us understand the differences in more detail.

Difference between the two types

Hemodialysis

• Where it is done: At home or a hospital.
• How often it is done: 3 to 5 times a week.
• Complexity of the procedure:

The dialysis machine (dialyzer) requires a vascular access which is basically a pair of artery and vein through which the blood in the body is pulled out of the body and in to the machine, cleaned using special filters and then cycled back to the body. Initially access is achieved by placing a temporary catheter in central veins, usually in the neck. Later a surgery is done to create a fistula in the forearm.

• Ability to work: During the entire duration of the dialysis, the patient is either sitting or lying on bed and cannot perform any other activities. Rest of the days, they are free to work.
• Side effects of the procedure: Fatigue, low blood pressure.
• Diet Restrictions: Salt and water intake are mainly restricted along with certain other food items which have high potassium and phosphorous.

Peritoneal Dialysis

• Where it is done: At home
• How often it is done: Daily, 4 to 6 times per day or in the night.
• Duration of the procedure: 3 to 5 hours per day in total
• Complexity of the procedure:

Using laparoscopic surgery, a peritoneal catheter is inserted into the lining of the abdominal wall (peritoneum), which provides an access to the abdominal cavity. The patient can use this access 2 weeks after it has been created.

On a daily basis, the patient must fill the abdominal cavity with a special fluid (dialysate filter), through this access point. The fluid cleans the blood through the internal walls of the abdomen and then drains into a collection bag which the patient or a caretaker must empty out.

• Ability to work: This procedure can be done at night, which means, the patient can perform his/her normal activities during the day. The person can even travel, as long as he/she is able to perform this procedure on his/her own, in a clean place.
• Side effects of the procedure: Risk of infection of the Catheter(or) abdomen and limitation of membrane function.
• Restrictions: There are fewer restrictions to diet with this procedure compared to hemodialysis.

Is dialysis at home possible?

Yes, dialysis can be done at home, and this type is called peritoneal dialysis, described above. It is a safe and effective option for people with end-stage kidney disease. It gives the person flexibility to do the procedure at his/her convenience, plus there is more flexibility on what he/she can eat or drink. The procedure is needle-free and has less side-effects. The person does not have to invest time, costs and energy to go to a hospital/clinic for dialysis. The procedure is not very complex, and one can do the same without assistance. To make it easy, most hospitals even provide training for a couple of weeks to familiarize the person and make him/her comfortable with the same.

Frequently Asked Questions

1. What is dialysis?

Dialysis is a treatment for kidney failure where the blood is cleaned through artificial means either inside or outside the body.

2. How does dialysis help in kidney failure?

Dialysis helps remove waste products from the blood that the kidneys can no longer filter out effectively due to kidney failure.

 3. What are the types of dialysis?

There are two types: Hemodialysis and Peritoneal Dialysis.

 4. What is Hemodialysis?

 Hemodialysis is a process where blood is cleaned outside the body using a dialysis machine and then returned back into the body.

5. What is Peritoneal Dialysis?

Peritoneal Dialysis involves putting a special fluid in the abdomen that absorbs waste from blood vessels in the abdominal cavity.

6. How often is dialysis done?

Hemodialysis is typically done 3 to 5 times a week, while Peritoneal Dialysis can be done daily, multiple times per day, or during the night.

7. Where can dialysis be done?

Hemodialysis can be done at home or a hospital, while Peritoneal Dialysis is usually done at home.

8. Are there any diet restrictions with dialysis?

Yes, diet restrictions mainly involve limiting salt and water intake, along with certain foods high in potassium and phosphorus. Peritoneal Dialysis generally has fewer diet restrictions compared to Hemodialysis.

9. Can patients continue their normal activities during dialysis?

During Hemodialysis, patients typically need to stay still, but on non-dialysis days, they can resume normal activities. Peritoneal Dialysis can be done at night, allowing patients to carry on with their daily activities during the day.

 

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Updated on 14 ^th Nov 2022