You are able to eat more and use fewer medications. You can do more of your daily activities and it is easier to work or travel. However, there are some people for whom peritoneal dialysis may not be appropriate. The abdomen or belly of some people, particularly those who are morbidly obese or those with multiple prior abdominal surgeries, may make peritoneal dialysis treatments difficult or impossible. Peritonitis infection of abdomen is an occasional complication although should be infrequent with appropriate precautions.
When making a decision about the type of treatment, you should take into consideration that peritoneal dialysis is usually a daily process, similar to the working of the kidney and may be more gentle with fluid removal from the body. Peritoneal dialysis is an effective form of dialysis, has been proven to be as good as hemodialysis.
Peritoneal dialysis is not for everyone. People must receive training and be able to perform correctly each of the steps of the treatment. A trained helper may also be used. All types of dialysis are expensive, but, for most patients, the federal government now pays 80 percent of all dialysis charges, while private insurance or state medical assistance pays the rest.
You can only drink a certain amount of fluid and you have to avoid a number of foods. Like hemodialysis, you need to undergo a certain procedure before you can start dialysis. For this treatment, a catheter will be placed in your belly.
This will be used to filter your blood. The process of doing this kind of dialysis is called an exchange, which needs to be completed four to six times per day. But you can easily conceal that with your clothes. Unlike hemodialysis, there are fewer restrictions when it comes to food and drink intake.
The blood is removed from the body and filtered through the artificial kidney. The filtered blood is then returned to the body with the help of a dialysis machine. To get the blood to flow to the artificial kidney, your doctor will perform surgery to create an entrance point vascular access into your blood vessels.
The three types of entrance points are:. Both the AV fistula and AV graft are designed for long-term dialysis treatments. People who receive AV fistulas are healed and ready to begin hemodialysis two to three months after their surgery. People who receive AV grafts are ready in two to three weeks. Catheters are designed for short-term or temporary use. Hemodialysis treatments usually last three to five hours and are performed three times per week.
However, hemodialysis treatment can also be completed in shorter, more frequent sessions. The length of treatment depends on your body size, the amount of waste in your body, and the current state of your health. This option is more common for people who need long-term treatment. Peritoneal dialysis involves surgery to implant a peritoneal dialysis PD catheter into your abdomen. The catheter helps filter your blood through the peritoneum, a membrane in your abdomen.
During treatment, a special fluid called dialysate flows into the peritoneum. The dialysate absorbs waste. This process takes a few hours and needs to be repeated four to six times per day.
This therapy is used primarily in the intensive care unit for people with acute kidney failure. A machine passes the blood through tubing. A filter then removes waste products and water.
The blood is returned to the body, along with replacement fluid. This procedure is performed 12 to 24 hours a day, generally every day. Peritoneal dialysis is associated with an increased risk for infections in or around the catheter site in the abdominal cavity.
For example, after catheter implantation, a person can experience peritonitis. Peritonitis is an infection of the membrane lining the abdominal wall. If you continue to have these symptoms while on dialysis, tell the healthcare provider performing the treatment.
This video explains how most people with kidney failure feel better after starting dialysis. When hemodialysis treatments are working and you keep to your ideal dry weight, your blood pressure should be well controlled. In addition, blood tests can show how well your hemodialysis treatments are working.
Read more about hemodialysis dose and adequacy. You could have a problem with your vascular access, which is the most common reason someone on hemodialysis needs to go to the hospital.
Any type of vascular access may. These problems can keep your treatments from working. You may need to have more procedures to replace or repair your access for it to work properly. Your doctor can change your dialysis solution to help avoid these problems. The longer and more frequent treatments of home hemodialysis are less likely to cause muscle cramps or rapid changes in blood pressure than standard in-center dialysis. You can lose blood if a needle comes out of your access or a tube comes out of the dialyzer.
To prevent blood loss, dialysis machines have a blood leak detector that sets off an alarm. If this problem occurs at the clinic, a nurse or technician will be on hand to act. You may need a few months to adjust to hemodialysis. Always report problems to your health care team, who often can treat side effects quickly and easily.
You can avoid many side effects by following an eating plan you develop with your dietitian, limiting liquid intake, and taking your medicines as directed. The dialysis social worker may be able to help you develop an end-of-life care plan before you stop dialysis. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public.
Kidney Failure What is Kidney Failure? Where can I have hemodialysis? How do I prepare for hemodialysis? What changes will I have to make when I start hemodialysis? How will I know if my hemodialysis is working? What are possible problems from hemodialysis? What happens if I have been on dialysis and I decide to stop? What happens during hemodialysis? During hemodialysis, your blood is pumped through a filter, called a dialyzer. In the filter, your blood flows inside hollow fibers that filter out wastes and extra salt and water.
Your doctor can adjust the balance of chemicals in the solution if your blood tests show your blood has too much or too little of certain minerals, such as potassium or calcium you have problems such as low blood pressure or muscle cramps during dialysis Can the dialyzer do everything my kidneys once did?
Dialysis center Most people go to a dialysis center for treatment. Getting longer overnight dialysis treatments means your days are free. Longer treatment sessions may reduce your symptoms. Home hemodialysis Home hemodialysis lets you have longer or more frequent dialysis, which comes closer to replacing the work healthy kidneys do—usually three to seven times per week, and with treatment sessions that last between 2 and 10 hours.
You can use standard home hemodialysis —three times a week or every other day for 3 to 5 hours short daily hemodialysis —5 to 7 days per week for 2 to 4 hours at a time nightly home hemodialysis —three to six times per week while you sleep Your doctor will decide how many treatments you need each week for daily or nightly home hemodialysis.
More dialysis filters your blood more thoroughly Compared with a standard hemodialysis schedule, daily or nightly home hemodialysis will let you eat and drink more normally take fewer blood pressure medicines Healthy kidneys work 24 hours a day, 7 days a week.
Getting more hemodialysis feels more like having healthy kidneys and lowers your chances for problems that are common with a standard hemodialysis schedule, such as painful muscle cramps from removing too much fluid too quickly high blood pressure, which can cause a headache or, in rare cases, a stroke low blood pressure, which can make you faint, feel sick to your stomach, or be more likely to fall high phosphate levels, which can weaken bones and make your skin itch Better quality of life Standard hemodialysis can make you feel tired or washed out for several hours after each treatment.
The home-training nurse may visit your home to help with your first at-home treatment. Dialysis center and home hemodialysis comparison Use the following chart to help you choose between treatment in a dialysis center or at home. Three to seven short or long treatments per week at times that work best for you. Availability Available in most communities; may require travel in some rural areas. Becoming more widely available as smaller equipment is developed.
You may need minor changes in your home to connect the machine to electricity and water.
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