Hemodialysis vs Peritoneal Dialysis

Once chronic kidney failure has been ascertained, a form of dialysis will be needed to keep you alive. As scary as this sounds, there is no reason why you cannot live a relatively normal life. My own hemodialysis story is in a sense a testament to what can happen if you do not weigh your options and control your illness at every turn of its meandering course to transplantation.

Both forms of dialysis require forethought and preparation. Despite this, in my experience, if you do not research your options most doctors will usher you down one of the two main dialysis paths without allowing you to make a choice. Granted, sometimes there can only be once choice, and in many situations, illnesses and conditions, you will not have the luxury to make a choice. The first thing to ascertain is whether you can make a decision, or whether your path is already set, and only a doctor will be able to tell you whether you are eligible. Ask first.

Peritoneal dialysis differs from Hemodialysis in that the blood is cleaned by a membrane inside the body (the peritoneum), and not outside. Dialysis fluid, which is primarily composed of a glucose solution and salts, is passed through a thin membrane that surrounds the exterior of organs in the abdomen. 

There are two kinds of Peritoneal Dialysis. 

1. APD - Automated Peritoneal Dialysis, is a an automated method of Dialysis which runs while you are sleeping. 8-12 liters of fluid will be exchanged during the course of a 8-10 hours sleep. You will also need to be monitored frequently by nurses and clinics due to the strict rules and guidelines which need to be met. 
2. CAPD - Continuous Ambulatory Peritoneal Dialysis, which cleans your body during the day. You will need to exchange the fluids every few hours, which can take 40 minutes per session (usually 4 times a day).

Hemodialysis is a treatment that cleans the blood through an artificial membrane outside of the body, in a machine like the one pictured above. Despite the scary looks, only a small amount of blood is outside the body at any given time, and while your nerves (the first few times) made make you feel faint, the blood loss certainly won't. 

In order to access the amount of blood needed to complete the treatment in a reasonable time-frame, a fistula (an artificially enlarged artery) will need to be grafted into your arm in a low profile day-surgery clinic. After the operation, the artery must be given time to heal (about a month) before treatment can begin. 

Two large dialysis needles will be inserted into your arm which carry your blood in-and-out of your body, and they will remain there for the duration of the treatment. While insertion can be uncomfortable (it is surprisingly painless -- well, it was for me, I will put it down to desensitization) the main discomfort lies in keeping your arm still for a few hours, not so much because of the feel of the needles, which you probably won't feel at all. 

Despite the weighty cons for both methods, the chance that you can either live in good health until your transplant, or life well without one is very good. There is also a great deal of research being poured into chronic kidney failure, and both treatments are becoming increasingly less uncomfortable.

Thank you for reading my hub. Regards, 

Thooghun.