Consumer Interest
Treatment Choices > Dialysis
Hemodialysis is a treatment that cleans and filters your blood by removing the waste products and extra fluid that your kidneys can no longer eliminate. Hemodialysis requires a machine and an artificial kidney that is called a dialyzer. During the hemodialysis treatment your blood is pumped by the machine through tubing to the dialyzer. In the dialyzer, your blood is filtered, waste products and extra fluid are removed. The filtered or 'cleaned' blood is then returned to your body.
In order to remove and return blood to your body, an access to your blood vessels must be made. This access is made during a surgical procedure in which a fistula is created or a graft is inserted under your skin. The fistula or graft is put in the lower or upper arm if possible; other places can be used if the arm is not suitable. Your surgeon will determine which access is best for you.
If treatments must be started before a fistula is created or a graft is inserted, a temporary catheter may be placed externally (outside your body) to allow for immediate access to your blood vessels.
Once your access has healed (matured) it can be used for treatment. Two needles are placed in the access at the start of each treatment and taken out at the end of each treatment. One needle is used to remove your blood for cleansing (filtering) and the other is used to return the filtered blood to your body.
Hemodialysis treatments are usually performed three times each week. The length of your treatment is decided by your doctor but usually lasts from 3 to 5 hours. The time depends on your body size, any remaining kidney function and activity level. During your treatment you can read, watch TV or socialize with others close to you in the facility.
Hemodialysis treatments are available in a dialysis facility (in-center) which may or may not be part of a hospital. Many units are in buildings that are not part of a hospital setting. Trained staff performs in-center dialysis treatments.
Peritoneal dialysis is a treatment where the peritoneal membrane (lining around the inside of your intestinal wall) is used to filter and cleanse the impurities, waste products and extra fluid from your body. Peritoneal dialysis uses a fluid called dialysate to remove fluid and waste products from your abdominal cavity and place them in the dialysate. The dialysate fluid acts like a magnet that attracts waste and excess fluid from the body.
Peritoneal dialysis uses a catheter that is surgically put into the abdominal cavity and attached to the bag of dialysate solution for the treatment. After the treatment, the catheter is disconnected from the bag of dialysate and covered to keep it clean.
You or your partner, in the comfort of your own home, perform the treatment. The treatment can be done safely in other locations so that you have the most flexible treatment arrangement. You can do the procedure at work or at school as well.
When your physician decides that your catheter is ready to use, training sessions will be arranged to teach you the best and safest way to perform dialysis. Trained dialysis staff will work with you to make your dialysis therapy and transition to independence as easy as possible. Trained staff are available to you on-call every day for emergencies if you have difficulty with your treatment at home.
The types of peritoneal dialysis are:
- Continuous ambulatory peritoneal dialysis (CAPD);
CAPD is done several times during the day. A set amount of fluid is placed into the abdominal cavity through your catheter. This fluid remains in the abdominal cavity for several hours and is then drained. The process is repeated 4 or 5 times daily. Each exchange takes about 30-40 minutes. The exchange schedule can be flexible to meet your needs. No machine is used for this type of treatment. YOU are in control.
- Continuous cycling peritoneal dialysis (CCPD).
CCPD is done at night using a machine called a cycler. The system automatically does the exchanges for you while you are sleeping. Most consumers must spend 8 to 10 hours every night to complete this process.
Peritoneal dialysis must be done every day. During your training, you are taught to follow specific procedures that allow you more freedom than on hemodialysis. It is a commitment that can be easy to follow. With encouragement from your family and health care team your lifestyle will require only minimal adaptation.