Types of dialysis

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1. Overview

The kidneys are responsible for filtering waste products and toxins from the blood. Dialysis is a procedure that replaces many of the normal roles of kidneys. The kidneys are pair organs, located behind the abdominal cavity.

Dialysis allows people to live a normal life even if their kidneys are not working properly. This process helps the body, completing the functions that kidneys fail to complete. The kidneys have several roles. One of them is to balance body fluids by adjusting the amount of urine that is excreted daily.

On hot days, the body sweats more. Thus, the kidneys will produce smaller amounts of water to be excreted in urine. On cold days, the body sweats less and the volume of urine will be higher to maintain a balance in the body. Another role of the kidneys is to remove waste that the body produces throughout the day.

When toxins are not removed properly from the blood, they accumulate in the body. The high level of waste in the blood is called azotemia. If the amount of waste increases, there is a bad feeling to the whole body level, called uremia.


1. Overview
2. When is dialysis required?
3. Types of dialysis
4. What should a patient know about dialysis

2. When is dialysis required?

Patients requiring dialysis when the toxins from the body reach a very high level that installs a general feeling of discomfort. Usually, waste values increase gradually. To decide if required dialysis will measure the creatinine and urea nitrogen levels in the blood. These are indicators that predict decreased ability of the kidneys to cleanse the body of waste.

Doctors use a test called urine creatinine clearance to assess renal function. The patient collects the urine in a container during the day. The quantity of waste found in urine and blood is estimated by measuring the creatinine levels. By comparison of these substances in blood and urine, the doctor will know how well work the kidneys. Usually, when creatinine clearance decreases to 10-12 ccmin, the patient needs dialysis.

Experts also use other indicators of patient status to determine if dialysis is needed or not. If the patient is experiencing major inability to remove excess water from the body or accuse heart or stomach problems or changes in taste or sensation in the feet, dialysis may be indicated even if creatinine clearance did not decrease below 10 – 12 ccmin level.

3. Types of dialysis

Dialysis is a process that replaces healthy kidney function when the kidney failure is diagnosed. Dialysis filters waste, eliminating additional fluids and restores the proper balance of chemicals in the blood. There are two main types of dialysis: hemodialysis and peritoneal dialysis.

Hemodialysis uses a semipermeable membrane called dialyser to cleanse the blood. The patient will be connected to the dialysis machine through tubes that are attached to blood vessels. Before starting hemodialysis treatment, the doctor will allow blood to enter and get out of the body by inserting a catheter into the blood vessels in the forearm or in the neck, upper chest and groin.

Peritoneal dialysis uses the peritoneal membrane as a filter to clear wastes and extra fluid from the body in order to determine the electrolyte levels return to normal. Peritoneal dialysis can be performed several times at night during sleep, including at home. Prior to initiating the procedure will insert a catheter into the abdomen.

4. What should a patient know about dialysis

The patient must follow different diets for these two types of dialysis. A dietitian will recommend a diet plan depending on the type of dialysis. There is not a type of dialysis recommended for everyone. For each of these types we can find pros and cons.

Pros and cons of the two types of dialysis:

Hemodialysis – Pro
- It is most often done by specialists who can evaluate any problem.
- It can be used including by patients with abdominal problems such as hernia or other disorder, acute inflammatory bowel disease (Crohn’s disease, ulcerative colitis).
- Allows contact with others during the procedure, considering that they can provide an important emotional support for the patient.

Peritoneal dialysis – Pro
- It provides greater freedom of movement. Peritoneal dialysis can take place at home or in any other clean place. It could be done including during sleep and without any other help. It does not require so much food and fluid restrictions as hemodialysis and uses no needles.
- It is a better option if the patients who suffer from bleeding or who are taking medications that interfere with blood clotting.

Hemodialysis – Cons
- The procedure usually must be done in a hospital or dialysis center and requires a fairly strict schedule: three days a week and lasts from three to five hours a day.
- Following this procedure the patient will be very tired during the day of treatment.
- It may cause various problems including low blood pressure, blood clots when the catheter is introduced in the abdomen.
- It assumes an increased risk of blood infections.

Peritoneal dialysis – Cons
- It can be done every day of the week.
- Can be difficult to control because of the technical aspects of the procedure.
- Increased risk of infection called peritonitis abdominal lining.

Decisions on hemodialysis or peritoneal dialysis choice will be taken not only by considering the health of the patient, but also his preferences.

Reasons to choose hemodialysis
- Hemodialysis involves a greater degree of comfort and there are always professionals involved in the procedure.
- Hemodialysis is not done every day of the week.
- If there are conditions or abdominal problems the doctor cannot chose peritoneal dialysis.

Reasons to choose peritoneal dialysis
- The patient lives far away or is difficult for him to reach is a dialysis center.
- Peritoneal dialysis requires fewer restrictions about food and fluid intake as in the hemodialysis.
- The person has clotting problems or taking drugs that interfere with blood clotting.



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