Dialysis CareWhen chronic kidney disease progresses to end stage renal disease (stage 5 kidney disease), patients will need dialysis to help clear the blood of toxins and fluid usually processed by the kidneys. The two main dialysis modalities are hemodialysis and peritoneal dialysis.
Hemodialysis involves using a machine that circulates your blood through a filter to help remove fluid and waste. Hemodialysis is most frequently done in a dialysis unit three times a week for three to four hours each time. Dialysis staff will monitor your dialysis while you are on the machine. This type of dialysis will involve creating an access such as a fistula or graft to be able to send blood to the machine and back.
Peritoneal dialysis (PD) is another option which can be performed at home. In peritoneal dialysis, dialysis solution is instilled into the abdominal cavity via a peritoneal dialysis catheter. Your abdomen has a membrane through which the waste and fluid can cross over to the dialysis solution. This is most commonly done overnight using a machine that cycles fluid in and out of the abdomen while one is sleeping. This may also be done manually exchanging 4 to 5 times a day if the characteristics of the abdominal membrane permit. Peritoneal dialysis will require training by a peritoneal dialysis nurse before one can perform this at home.
Each of the dialysis modalities has their own advantages and disadvantages. You and your nephrologist will make a decision of which is right for you depending on your medical conditions and lifestyle.