The second installment of our “Demystifying Dialysis” initiative shares the key differences between home hemolysis and peritoneal dialysis. This week Dr. Ali takes us through the pros and cons of each along with key points Nephrologists wish patients were more aware of when selecting their dialysis options.
Different Dialysis Types
Regardless of modality, dialysis aims to compensate for the functions performed by healthy kidneys. Ideally, dialysis design would mimic how a normal kidney maintains steady filtration, and keep up with the body’s metabolic waste production. With that in perspective, dialysis needs to be done slowly and steadily over time to compensate for 24/7 function in limited hours per day. Home home dialysis with its slower flow rates and frequency is the one closest to the way how actual kidneys work.
Pros of PD
One of the greatest benefits of Peritoneal dialysis is that it is a ‘natural way to dialyze’ because you use your stomach’s membrane to clean the blood rather than an artificial membrane. PD provides more normalcy in diet and lifestyle and better volume control of how much fluid gets filtered through your body. There is less chance of cramping and symptoms like headache and nausea. PD is easier to learn and won’t leave you as tired as in-clinic hemodialysis.
Pros of Home Hemo
Similar to home PD, home hemodialysis is slow and typically conducted 4-5 times a week in 3-4 hour sessions. An alternative to short daily home hemodialysis is Nocturnal Home Hemodialysis which can be done at night while you rest. Eligibility for the nocturnal option varies, however, with most patients needing at least 6 months of daytime dialysis before they can move to it.
In-Center Hemo
In-center has a much faster process compared to both at-home options. For many, in-clinic can be a great support if you desire community support or require assistance in administering dialysis. For patients prone to heart issues, your doctor may be cautious of recommending in-clinic hemodialysis since the intense rapid filtration can strain the heart; however, for most, this manifests into symptoms like fatigue.
Future Trends in Dialysis
The adoption of Home Hemodialysis and Peritoneal Dialysis is steadily increasing as kidney disease treatment options evolve. Following the COVID-19 pandemic, there has been a significant shift towards home dialysis—a trend that continues to gain momentum. While many people must first be educated on home dialysis, those who choose it can return to in-center treatment if it doesn’t align with their needs. Dr. Ali’s biggest takeaway is to not let the fear of the unknown often prevent patients from fully exploring the positive impacts of home dialysis!
