Nephrology
Dialysis
Peritoneal dialysis is a way to remove waste products from your blood when your kidneys can no longer do the job adequately. A cleansing fluid flows through a tube (catheter) into part of your abdomen and filters waste products from your blood. After a prescribed period of time, the fluid with filtered waste products flows out of your abdomen and is discarded.
Peritoneal dialysis differs from haemodialysis, a more commonly used blood-filtering procedure. With peritoneal dialysis, you can give yourself treatments at home, at work or while traveling. Peritoneal dialysis isn’t an option for everyone with kidney failure. You need manual dexterity and the ability to care for yourself at home, or a reliable caregiver.
Why it's done?
Dialysis is required if your kidneys don’t function adequately on their own. Kidney damage generally progresses over a number of years as a result of long-term conditions, such as:
- Diabetes
- High Blood Pressure
- Kidney inflammation (glomerulonephritis)
- Multiple cysts in the kidneys (polycystic kidney disease)
The benefits of peritoneal dialysis compared with haemodialysis can include:
Greater lifestyle flexibility and independence. These can be especially important if you work, travel or live far from a haemodialysis centre. More flexible dietary guidelines. Peritoneal dialysis is done more continuously than hemodialysis, resulting in less accumulation of potassium, sodium and fluid.
More stable blood chemistry and body hydration. Peritoneal dialysis doesn’t require intravenous (IV) access, which can disrupt your circulation and fluid levels. Longer lasting residual kidney function. People who use peritoneal dialysis might retain kidney function slightly longer than people who use hemodialysis. Your doctor will discuss with you the type of dialysis that’s best for you. Factors to consider include:
- Your kidney function, as measured by blood and urine tests
- Your overall health
- Your personal preferences
- Your home situation
- Peritoneal dialysis may be the better option if you:
- Can’t tolerate the rapid changes of fluid balance associated with hemodialysis
- Want to minimize the disruption of your daily activities, and work or travel more easily
- Have some residual kidney function
Peritoneal dialysis might not work if you have:
- Extensive surgical scars in your abdomen
- A large area of weakened abdominal muscle (hernia)
- Limited ability to care for yourself, or a lack of caregiving support
- Inflammatory bowel disease or frequent bouts of diverticulitis
- Protein malnutrition
- Critical illness
- Most people who start dialysis with peritoneal dialysis will eventually experience a decline in kidney function and will need hemodialysis or kidney transplant.
Heamodialysis
Hemodialysis, also spelled haemodialysis, commonly called kidney dialysis or simply dialysis, is a process of purifying the blood of a person whose kidneys are not working normally.
This type of dialysis achieves the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of kidney failure.
Hemodialysis is one of three renal replacement therapies (the other two being kidney transplant and peritoneal dialysis). An alternative method for extracorporeal separation of blood components such as plasma or cells is apheresis.
Hemodialysis can be an outpatient or inpatient therapy. Routine hemodialysis is conducted in a dialysis outpatient facility, either a purpose built room in a hospital or a dedicated, stand-alone clinic. Less frequently hemodialysis is done at home. Dialysis treatments in a clinic are initiated and managed by specialized staff made up of nurses and technicians; dialysis treatments at home can be self-initiated and managed or done jointly with the assistance of a trained helper who is usually a family member.
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