Hemodialysis vs Peritoneal Dialysis 

When kidney failure occurs, toxins start building up in the body. It is necessary to find a replacement for kidney function, a method that allows for filtering the blood, cleaning it and returning it to the body. The 2 common forms of dialysis include Hemodialysis and Peritoneal Dialysis.

The general consensus is that neither dialysis method is superior to the other, and that the pros and cons of each method should be researched and each patient’s individual life style taken into consideration when deciding between the two.

Whether the choice made is hemodialysis or peritoneal dialysis, it is not final and it is possible to move from one to the other in case of need or if complications arise.

Comparison between hemodialysis and peritoneal dialysis

How is the procedure done?

Hemodialysis
Procedure uses a dialyzer (manmade membrane). 2 needles are inserted through an access point and blood is drawn from the body via fistula, graft or catheter and then filtered. Fluid, waste and chemicals are removed, and the filtered blood is returned to the body.

Peritoneal dialysis
Procedure uses the peritoneal membrane (the lining of the abdominal cavity) and dialysate (solution). Dialysate is transferred via small tube into abdomen. Fluid, waste and chemicals move from blood to dialysate. Dialysate is then drained from the abdomen and the process starts once more.

Dialysis access

Hemodialysis
Via an arteriovenous fistula, arteriovenous graft or dialysis catheter, placed in advance in arm, leg or groin. Fistula is placed 3-12 months prior to treatment start, graft 2-3 weeks in advance. Catheter can be used immediately (usually for short term).

Peritoneal dialysis
Via catheter placed in abdomen at least 2 weeks prior to start of treatment.

Independence

Hemodialysis
Carried out by health professionals or at home by a caregiver who has undergone instruction.

Peritoneal dialysis
Can be done by patient.

Travel

Hemodialysis
Requires planning and making arrangements with dialysis centers. Home equipment is bulky and hard to move.

Peritoneal dialysis
Equipment is portable and can be taken with you, can be done everywhere and anywhere.

Travel

Hemodialysis
Dietary and fluid restrictions:
– Requires high protein
– Limited potassium
– Limited fluid intake
– Avoidance of salt
– Limit phosphorous

Peritoneal dialysis
Fewer restrictions, may need to restrict calories.

Where is the procedure done

Hemodialysis
Usually at a hospital or dialysis center. Can be done at home after properly adapting the house and having a caretaker trained in HD use.

Peritoneal dialysis
At home, work or where ever you want.

How often is the procedure done

Hemodialysis
Usually 3 days a week, each session lasting 3-5 hours. If done at home – 1.5 hours of daily sessions, or nightly.

Peritoneal dialysis
4-6 sessions (exchanges) daily, each exchange lasting 15-30 minutes, can be done while sleeping, approx. 36 to 42 weekly hours.

Flexibility

Hemodialysis
Ridged scheduling, life is planned around sessions.

Peritoneal dialysis
Portable equipment, allows for flexible lifestyle and independence.

Fluctuation of symptoms

Hemodialysis
Tiredness after treatment, lethargy and weakness as next appointment draws close.

Peritoneal dialysis
Continuous therapy allows for minimal fluctuation of symptoms.

Fluctuation of symptoms

Hemodialysis
– Blood clots
– Infection
– Low blood pressure
– Anemia
– Pericarditis (inflammation of the membrane around the heart)
– Sepsis
– Access site complications such as infections, aneurysm or blockage

Peritoneal dialysis
– Developing peritonitis (inflammation of the abdomen membrane)
– Scarring of the peritoneum
– Abdominal muscle weakening
– High blood sugar due to the dextrose in the dialysate
– Hernia
– Eventual ineffectively of procedure

Possible Side effects

Hemodialysis
– Muscle cramps
– Hypotension
– Dizziness
– Nausea
– High blood potassium levels
– Depression
– Itchiness
– Fatigue
– Loss of libido
– Anxiety
– Dry mouth

Peritoneal dialysis
– Weight gain
– Reduction in protein levels leading to malnutrition
– Fatigue

Contraindications

Hemodialysis
– Severe hypotension or anemia
– Arrhythmia, myocardial infraction
– Advanced malignant tumor
– Intracranial pressure/hemorrhaging
– Uncontrolled diabetes

Peritoneal dialysis
– Extensive abdominal scarring
– Hernia
– Unable to care for oneself, or no caregiver
– Inflammatory bowel disease
– Recurring diverticulitis
– Protein malnutrition
– Critical illness

Limitations

Hemodialysis
Need to avoid pressure being placed on access limb.

Peritoneal dialysis
Limit on certain medications, no baths (may shower only), no hot tubs, no swimming in a lake, pond, river or non-chlorinated pool.

 

Follow our blog to read more about the various aspects of coping with kidney failure, end stage renal disease and various treatments options, including VasQ, our innovative support device for AV fistulas.