Living with kidney failure means you are going to have to choose dialysis methods to perform the essential functions your kidneys can no longer manage. There are two major forms of dialysis, which are Hemodialysis (HD) & Peritoneal Dialysis (PD). They both have their own differences in procedure, pros and cons. However, these distinctions are key when thinking about what kind of treatment is right for you medically and at home.
Thus, in this article, we will elaborate on Hemodialysis vs Peritoneal dialysis with the pros and cons of both.
What is Hemodialysis?
Hemodialysis is when blood is filtered outside of yourself through an external machine to get rid of waste products and extra fluid. This will use vascular access, a surgically created entry in your arm that allows blood to leave your body, go through some pipes to the dialysis machine and go back.
Hemodialysis is usually done at a dialysis centre under medical supervision. Usually, it has to be done three times per week, each lasting about four hours, and will serve as treatment. Home hemodialysis is a better option, but you must train extensively and have the kind of necessary environment at your home to accommodate this.
Advantages
- Effective removal of waste: A hemodialysis machine effectively clears the bloodstream of waste and excess fluids, which in turn can relieve symptoms due to kidney failure (anorexia, fatigue, swelling).
- Proven Medical Supervision: Dialysis treatments provide regular supervision of the healthcare workers involved while treating patients in a dialysis facility so that any complications are managed right away.
Disadvantages
- Time-Consuming: Thrice-weekly sessions can be very time-consuming and potentially take away from your work or leisure time.
- Restrictions on Diet: Patients have to follow extremely limiting dietary restrictions to keep fluids, potassium, phosphorus and sodium out of the system in between their sessions.
- Complications of Vascular Access: When forming the tourniquet/prolonged tamponade can lead to other vascular access problems like infection or clotting.
What is Peritoneal Dialysis?
Peritoneal dialysis uses the peritoneum, the sac that lines your abdomen, as a natural filter. A catheter is inserted surgically into the abdominal space through which a dialysis solution is inserted. It absorbs waste and excess fluids in the blood vessels of the peritoneum and then drains them out.
Peritoneal dialysis is primarily performed at home for more freedom. There are two main types:
- Continuous Ambulatory Peritoneal Dialysis (CAPD): The patient manually exchanges four to six times each day. The exchange takes approximately 30 minutes.
- Automated Peritoneal Dialysis (APD): Overnight, while sleeping machine automatically exchanges.
Advantages
- Lifestyle Flexibility: You can exercise at home or the office, on your commute and even while travelling.
- Long-Term Treatment: The more gradual management of PD more closely parallels normal kidney function, reducing blood chemistry and daily fluctuation in well-being.
- Less Dietary Restriction: Generally, patients have fewer dietary restrictions on fluid and food compared to hemodialysis.
- No Needles Required: The cath has no vascular access, and the PD fluids can be added without needles.
Disadvantages
- Once Per Day: Keeps you in a daily session. Daily sessions require habit and dedication.
- Risk of Infection: A Catheter increases the risk of peritonitis, an abdominal lining infection.
- Storage: Some space to store dialysis supplies at home.
Comparing Hemodialysis and Peritoneal Dialysis
1. Frequency of Treatment
- Hemodialysis: Normally conducted at least 3 times per week, 4 hours at a time.
- Peritoneal Dialysis: Manual daily exchanges all day long.
2. Treatment Setting
- Hemodialysis: Administered at a dialysis clinic under the supervision of medical personnel or at home with special access.
- Peritoneal Dialysis: Home-based only, work or on-the-go travel capability for the method.
3. Diets and Nutritional Needs
- Hemodialysis: Strict fluid, potassium, phosphorus and sodium restrictions to limit residuals.
- Peritoneal Dialysis: Less restrictive, allowing a wider diet and better fluid equilibrium.
4. Equipment and Setup
- Hemodialysis: Permeable hemodialysis machine and site (either AV fistula or graft in the extremity being used, must have an available vascular access point).
- Peritoneal Dialysis: Peritoneal catheter implanted into the abdomen (fixed depending on how much solution to use in a day, and where the dialysate can be stored)
5. Independence and Lifestyle Options
- Hemodialysis: Takes the form of timed appointments at a dialysis centre, which decreases flexibility.
- Peritoneal Dialysis: Gives more independence because you can do it at home, and hence, an easier life.
6. Medical Supervision
- Hemodialysis: An even more motivated term is dialysis under hemodynamic supervision at the dialysis unit to get medical assistance immediately if necessary.
- Peritoneal Dialysis: Train the patient and self-monitor, as opposed to regular follow-up with medical supervision, resulting in lifelong patient management.
What to Take into Account When Deciding Between HD and PD?
- Lifestyle and Schedule: Think about your day-to-day life, workload, and frequency of travel. PD can have more freedom, and the Hemodialysis machine sticks to a set schedule.
- Medical Issues: Some medical conditions may make one form of dialysis more appropriate than the other, such as extensive abdominal surgeries. PD is contraindicated.
- Support System: For home-based care, evaluate family or caregiver availability.
- Personal Choice: Some like the do-it-yourself aspect of home treatment management, while others feel they need a little more regular professional supervision.
- Body Image and Comfort: The catheter for continuous and vascular access to HD or comfort care can help determine your preference in relation to body image.
In Conclusion
Hemodialysis and peritoneal dialysis are both viable treatment options for kidney failure, each with its downsides to consider. Hemodialysis machine suppliers are vitally important to delivering advanced technology in order to deliver effective treatment of kidney failure patients.
Hemodialysis machine cost will differ based on features, brand, and specifications, making it essential to choose the right model for both efficiency and affordability. It is then up to you and your healthcare team to discuss the merits of each together, depending upon your condition, but also your personal life/lifestyle and preferences. You can then choose between dialysis methods that are well aligned with your needs and will improve your quality of life with full comprehension of the two options.
For additional information and personalised advice, you can discuss with your nephrologist or health care provider.