By Lila Havens, Staff Writer, myOptumHealth
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The kidneys perform a number of processes that are vital to health. Among other things, they filter harmful wastes from the blood, and they keep the correct balance of fluid and minerals.
Some people have diseases that damage their kidneys and reduce their ability to function properly. When the kidneys are no longer able to do their job, it is called kidney failure, or end-stage renal disease (ESRD). At that point a process called dialysis is needed to do the work of the failing kidneys.
What is dialysis?
Dialysis is a treatment that can take the place of the kidneys. Dialysis can:
- Remove wastes and excess salt and fluid from the blood
- Maintain a safe balance of minerals in the blood
- Help control blood pressure
Dialysis does not cure kidney failure, but it can keep you alive and feeling better.
How is dialysis done?
There are two main types of dialysis: hemodialysis and peritoneal dialysis.
Hemodialysis uses a large machine to filter the blood. The blood flows slowly out of your body through tubes and into the machine (called a dialyzer). Then it is returned clean to your body.
To do dialysis, you first need an access site (called a vascular access) where the blood can leave and return to the body. This access site usually is placed in an arm or leg, and the site may take a few weeks to prepare.
Hemodialysis usually takes 3 to 5 hours, and it must be done on a strict schedule. Most people go three times a week to a dialysis center for treatment.
Peritoneal dialysis is completely different from hemodialysis. The filtering is done within your body using the lining of the belly (peritoneum).
With peritoneal dialysis, dialysis solution is put through a soft tube (catheter) into your belly. The inside walls of your belly are lined with a membrane called the peritoneum, which allows waste products and extra fluid to pass from your blood into the dialysis solution. The solution contains a sugar called dextrose, which pulls wastes and extra fluid into the abdominal cavity. These wastes and fluid are removed from your body when the dialysis solution is drained.
Before peritoneal dialysis can be done, you will have a simple operation to place the peritoneal catheter in your belly. Infection is a common problem with this type of dialysis, so it is very important to take precautions to keep the catheter clean and germ-free.
The time it takes to fill and drain the dialysis solution (usually about 30 minutes) is called an exchange. The dwell time is how long the solution is left in the abdomen. Different types of peritoneal dialysis have different schedules of daily exchanges. Many people do four exchanges a day with dwell times of 4 to 6 hours. Some use a machine called a cycler that fills and drains the solution while they sleep.
Is one type better or worse?
Each type of dialysis has pros and cons. Which type to use is a personal decision that should be made after considering all issues. Some points to consider:
- Hemodialysis is done three times a week. Peritoneal dialysis must be done every day without fail.
- Hemodialysis is usually done at a dialysis center. Peritoneal dialysis can be done at home, so it may be more convenient or practical for some people.
- Hemodialysis is done by experts so the risk of infection is very low. Peritoneal dialysis carries the risk of a serious abdominal infection (peritonitis).
Your doctor can help you decide which type of dialysis might be best for you.
Are there options other than dialysis?
The only other choice is a kidney transplant. You only need one healthy kidney to live, so this may be a good option if you are a candidate and a donor organ is available.
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