If dialysis is recommended for you, you’ll often be entitled to choose whether to receive hemodialysis or peritoneal dialysis. All dialysis procedures are equally effective for most individuals, so it is typically a matter of personal preference. Hemodialysis may be recommended for people who are unable to carry out peritoneal dialysis themselves, such as those who are visually impaired, have dementia, or are in a poor state of health.
Any decision you make about whichever procedure to have will not be final. It’s possible to move from one to the other. With this being said, let us explore the pros and cons of each type of dialysis procedure:
The advantage of hemodialysis is that you have 4 days of dialysis per week. The dialysis center protocol usually involves the use of a dialysis machine 3 days a week, with each treatment generally lasting about 4 hours. You’re going to need to plan your life around these meetings. As the appointments are conducted in a dialysis facility, you may need to travel regularly for care. But it might be important to learn how to use the equipment at home.
You can choose when and where to have dialysis treatments with your home hemodialysis. You might also be required to have dialysis overnight. This might allow you to have a normal routine and travel with the machine.
If you are receiving treatment in a dialysis facility and you are traveling to another country you will need to plan transportation to dialysis centers in advance. Inform the dialysis center workers well in advance, as they may be able to arrange for you to be sent to the dialysis facility at your location. The Global Dialysis website has a database of dialysis units across the world, but these units may charge a fee.
Another downside to hemodialysis is that your food and the amount of fluid you consume need to be reduced. Most patients who are undergoing hemodialysis at the dialysis facility have to restrict other products and are typically told not to consume more than a few cups of fluid a day. Nevertheless, evidence suggests that doing more frequent dialysis sessions at home will help you receive less food and fluid restrictions.
Like hemodialysis, the benefit of peritoneal dialysis is that daily dialysis visits are not necessary and can be done at home. There are also fewer restrictions on food and fluid consumption for patients with peritoneal dialysis relative to those with hemodialysis.
One of the main drawbacks to peritoneal dialysis is that it has to be done every day, which could potentially annoying or inconvenient for you. You may also find it frustrating that a thin tube (catheter) is still stuck in your abdomen, although it can often be covered beneath clothes.
In rare cases, your peritoneum may gradually become thickened and scarred. Some people may need to switch to hemodialysis after a few years to stop this happening.
Another drawback of peritoneal dialysis is that the dialysis fluid used can cause a reduction in protein levels, which can lead to a lack of energy and, in some cases, malnutrition. Weight gain is also a possible side effect.