There are two main types of dialysis: hemodialysis and peritoneal dialysis. Hemodialysis uses a special type of filter, “dialyzer,” to remove excess waste products and water from the body. Peritoneal dialysis uses a fluid that is placed into the patient’s stomach cavity through a special plastic tube to remove excess waste products and fluid from the body.
Hemodialysis removes wastes and water by circulating blood outside the body through an external filter, called a dialyzer, that contains a semipermeable membrane.
During hemodialysis, blood passes from the patient’s body through the dialyzer in the dialysis machine. You are connected to the dialyzer by tubes attached to your blood vessels. For this procedure, the patient has a specialized plastic tube placed between an artery and a vein in the arm or leg (called a “graft”). This is called the dialysis access. Sometimes, a direct connection is made between an artery and a vein in the arm. This procedure is called a ” fistula.” An access can also be created on a temporary basis through a cathether located in your neck, upper chest, or groin. Needles are then placed in the graft or fistula, and blood passes to the dialysis machine, through the filter, and back to the patient. In the dialysis machine, a solution on the other side of the filter receives the waste products from the patient.
Hemodialyis is usually conducted in an outpatient dialysis treatment center three times per week, with treatment times between 3 to 6 hours.
Hemodialysis may also be conducted at home. A small but growing number of clinics offer home HD in addition to standard HD treatments. The patient starts learning to do treatments at the clinic, working with a dialysis nurse. Most people who do home HD have helpers who train with them at the clinic. The helper can be a family member, neighbor, or close friend. Some programs do not require a helper if the patient can do all the tasks alone.
Peritoneal dialysis requires the patient and their family to play a more active role in their dialysis treatment. Proper sanitary conditions are absolutely essential for peritioneal dialysis, and a very clean surface on the abdomen where treatment is administered is required, in order to prevent infection.
Peritoneal dialysis uses the patient’s own body tissues inside of the abdominal cavity, or the peritoneal membrane, to act as the filter. A plastic tube called a “dialysis catheter” is placed through the abdominal wall into the abdominal cavity to act as the dialysis access. A special fluid is then flushed into the abdominal cavity and washes around the intestines. The intestinal walls act as a filter between this fluid and the blood stream. By using different types of solutions, waste products and excess water can be removed from the body through this process.
As an alternative to this treatment, some patients on peritoneal dialysis use a machine called a “cycler.” This cycler is used every night. Five to six bags of dialysis fluid is used on the cycler and the machine automatically changes the fluid while the patient sleeps.
There are pros and cons to both types of dialysis. Peritoneal dialysis is not recommended for patients with abdominal adhesions or other abdominal defects, such as a hernia or diverticulitis.
You need to consult with your Nephrologists and the dialysis staff to understand and decide the best dialysis treatment method for your own particular situation.
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See also the following National Institute of Health Resource