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Hemodialysis vs Peritoneal Dialysis

Updated on July 19, 2013

Once chronic kidney failure has been ascertained, a form of dialysis will be needed to keep you alive. As scary as this sounds, there is no reason why you cannot live a relatively normal life. My own hemodialysis story is in a sense a testament to what can happen if you do not weigh your options and control your illness at every turn of its meandering course to transplantation.

Both forms of dialysis require forethought and preparation. Despite this, in my experience, if you do not research your options most doctors will usher you down one of the two main dialysis paths without allowing you to make a choice. Granted, sometimes there can only be once choice, and in many situations, illnesses and conditions, you will not have the luxury to make a choice. The first thing to ascertain is whether you can make a decision, or whether your path is already set, and only a doctor will be able to tell you whether you are eligible. Ask first.

PROS

  • A great deal more freedom than Hemodialyis
  • Efficient cleansing of the blood
  • Less painful and exhausting than Hemodialysis
  • More relaxed diet and water intake rules compared to Hemodialysis
  • No vascular acess
  • Less problems with blood pressure

CONS

  • Leaks and Inflammation
  • You are not as well monitored by doctors and nurses (this may be an advantage depending on your outlook)
  • Dangerous Infection (Peritonitis)
  • Damage to the Peritoneal membrane can condition its efficiency.
  • Chronic back pain and possible anemia.
  • Nutritional complications

Peritoneal Dialysis

Peritoneal dialysis differs from Hemodialysis in that the blood is cleaned by a membrane inside the body (the peritoneum), and not outside. Dialysis fluid, which is primarily composed of a glucose solution and salts, is passed through a thin membrane that surrounds the exterior of organs in the abdomen. 

There are two kinds of Peritoneal Dialysis. 

  1. APD - Automated Peritoneal Dialysis, is an automated method of Dialysis which runs while you are sleeping. 8-12 liters of fluid will be exchanged during the course of a 8-10 hours sleep. You will also need to be monitored frequently by nurses and clinics due to the strict rules and guidelines which need to be met. 
  2. CAPD - Continuous Ambulatory Peritoneal Dialysis, which cleans your body during the day. You will need to exchange the fluids every few hours, which can take 40 minutes per session (usually 4 times a day).
Another detail to keep in mind is the implantation of a catheter (Tenckhoff catheter) to allow access to your Peritoneal cavity. This can be an uncomfortable experience. 

Hemodialysis Treatment

A typical (if rather bare) example of what to expect in a Hemodialysis clinic.
A typical (if rather bare) example of what to expect in a Hemodialysis clinic.

PROS

  • Very thorough cleansing
  • Constantly monitored 
  • After treatment you will not have to worry about Dialysis until the next treatment

CONS

  • Can be exhausting and Painful
  • Strict water intake limitations (thirst)
  • Strict Diet (maintaining low phosphorus and potassium intakes)
  • The Fistula can cause long-term cardio vascular problems
  • The Fistula can close, and you will need to make another.
  • Limited freedom

Hemodialysis

Hemodialysis is a treatment that cleans the blood through an artificial membrane outside of the body, in a machine like the one pictured above. Despite the scary looks, only a small amount of blood is outside the body at any given time, and while your nerves (the first few times) made make you feel faint, the blood loss certainly won't. 

In order to access the amount of blood needed to complete the treatment in a reasonable time-frame, a fistula (an artificially enlarged artery) will need to be grafted into your arm in a low profile day-surgery clinic. After the operation, the artery must be given time to heal (about a month) before treatment can begin. 

Two large dialysis needles will be inserted into your arm which carry your blood in-and-out of your body, and they will remain there for the duration of the treatment. While insertion can be uncomfortable (it is surprisingly painless -- well, it was for me, I will put it down to desensitization) the main discomfort lies in keeping your arm still for a few hours, not so much because of the feel of the needles, which you probably won't feel at all. 

How hemodialysis works!

Peritoneal Dialysis

Conclusion

Despite the weighty cons for both methods, the chance that you can either live in good health until your transplant, or life well without one is very good. There is also a great deal of research being poured into chronic kidney failure, and both treatments are becoming increasingly less uncomfortable.

Thank you for reading my hub. Regards, 

Thooghun.

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    • cherylvanhoorn profile image

      cherylvanhoorn 

      6 years ago from Sydney

      That was a wonderfully informative hub and one I take to heart. My husband is on home heamodialysis and I have worked as a renal nurse and a transplant nurse.

      It is a soul destroying disease and like you my husband is waiting that magic phone call.

      Good luck!

    • Don Bobbitt profile image

      Don Bobbitt 

      6 years ago from Ruskin Florida

      Great Hub, especially for the newbie Kidney Failure patient.

      I have used HEMO as well as PERItoneal Dialysis. I loved the freedom I got from PERI, and was on it for over 18 months.

      Eventually, My brother gave mr a Kidney in '96 and It and I are still ticking.

      Thanks again. Voted Up and interesting, plus I am going to share it with my followers.

    • profile image

      guddu 

      7 years ago

      thanks , this was informative. my father has started doing CAPD Peritoneal Dialysis, although I had not read this before taking the decision , I did go through what doctor's recommended. This helped me to understand my decsion and gives me more confidence.

    • profile image

      Greg 

      7 years ago

      This is a very detailed article which compares hemodialysis and peritoneal dialysis. I will refer my readers to this.

    • thooghun profile imageAUTHOR

      James D. Preston 

      8 years ago from Rome, Italy

      Thank you stars!

    • stars439 profile image

      stars439 

      8 years ago from Louisiana, The Magnolia and Pelican State.

      Great hub, and very informative. God Bless You Dear Heart, and I will include you in my prayers always before I sleep.

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