Once a chronic kidney failure (previous terminology) is diagnosed and conservative options are unavailable then an individual with chronic kidney disease stage V or end stage kidney disease are advised to undergo renal replacement therapy. Options for renal replacement therapy are hemodialysis, peritoneal dialysis or kidney transplantation. Here we shall discuss about hemodialysis and peritoneal dialysis as options. Both these procedures are equally efficacious for those whose kidney can no longer filter excess fluid and waste from blood through urination. Both these procedures have significant differences in their process, timings, and daily life adjustments.
A Closer Look at Hemodialysis
The process of using an external artificial filter (dialyzer) to remove impurities from the blood stream is hemodialysis. This process is usually performed at the hospital as it requires multiple facilities such as ultra pure water, hemodialysis machines, blood tubings, dialyzers, personnel to take care of vascular access (from where the blood is drawn) and requires close monitoring of vitals. Typically this procedure is done thrice a week, for 4hours or more for each session at the dialysis center. Blood pumped through the dialyzer, helps in exchange of wastes with required salts and also helps in fluid removal. The blood is drawn out of the body through a vascular access which can be an arteriovenous fistula (where individual’s artery and vein in the upper limb (usually) are joined surgically so as to increase the flow of blood – this is usually created few months prior to initiation of planned dialysis); a central venous catheter (placed into the big veins of the body (in the neck or thigh)) can be used in cases of emergency or if immediate initiation of hemodialysis is required); in some cases arteriovenous grafts are also used as vascular accesses
● Advantages: Suits most individuals and is an efficient way to manage removal of wastes and excess fluid in the body. Also helps tackle emergencies (requiring emergency dialysis)
● Disadvantages: Requires frequent visits to the hospital
Getting to Know Peritoneal Dialysis
Use of abdomen lining (called peritoneum) as natural filter so as to remove the wastes and fluid is peritoneal dialysis. A special fluid is installed into the abdomen via a catheter (tube) placed in to the abdomen surgically and the fluid is left in the abdomen for 4hours or more so that the wastes and useful electrolytes can be exchanged across the peritoneum and also fluid removal can occur in a gradual manner. As this is a slow process, the manual process is usually performed three to four times a day in manual method and overnight in multiple cycles via a machine called cycler. How this procedure is performed is taught to the individual who performs it and needs to be done meticulously to avoid any infections.
● Advantages: Scheduling can be flexible, can be performed at the comfort of home, with great independence. Usually helpful in individuals with poor heart function or individuals who want greater independence – as they travel a lot
● Disadvantages: Requires aseptic precautions to be maintained so as to avoid infections (as it is performed by self). Change of hands / other individuals are not to perform this procedure unless trained at the medical center.
Choosing What’s Best for You
Deciding between peritoneal and hemodialysis dialysis can be a personal decision and will also be based on the medical condition of the individual. Choice can also be made based on lifestyle, support system (if hemodialysis centers are far away), underlying medical conditions and personal choice. By consulting a nephrologist it's easy to understand the differences, advantages and disadvantages of each procedure.
● Think About Your Health: Specific medical conditions particularly might decide on one over the other.
● Consider Your Lifestyle: Before deciding the procedure, consider travel plans, work schedules, and family commitments.
● Evaluate Your Readiness for Self-Care: More self care is required for peritoneal dialysis.
● Assess Your Support Network: Look into your family and friends who can provide assistance.
NU Hospitals is a renowned health care provider we specialize in urology and nephrology. With a strong focus on caring for patients, we offer a vast dialysis service, which includes both peritoneal and hemodialysis dialysis. Our team of experts will guide and support throughout your treatment.
Understand, the goal is to find the procedure that suits best based on individual needs and lifestyle. While deciding may be difficult, we NU Hospitals are here to help.
Going Beyond the Basics
Both peritoneal and hemodialysis dialysis required careful management. Regular health checks, timely medication, and dietary restrictions are important for better treatment outcomes. Additionally, both peritoneal and hemodialysis dialysis comes with advantages and disadvantages.
It's important to discuss these details with your healthcare provider so as to meet your specific needs.
Importantly, the best dialysis procedure is the one which helps in maintaining quality of life while managing kidney disease effectively. With utmost care and guidance, you can take your decision and start the dialysis procedure with confidence.
