Types of Dialysis
Dialysis is a way to remove the waste products and extra water from the blood of patients with kidney failure. The two main types of dialysis are hemodialysis and peritoneal dialysis.
Hemodialysis
The Procedure
In hemodialysis, your blood is allowed to flow, a few ounces at a time, through a machine called a dialyzer. The dialyzer is a canister that contains thousands of fibers that filter out the wastes and extra fluid. The clean blood is then returned to the body through a different tube. Removing the harmful wastes and extra salt and fluids helps control blood pressure and keep the proper balance of chemicals like potassium and sodium in the body.
Adjusting to Hemodialysis
One of the biggest adjustments when starting hemodialysis treatments is following a rigid schedule. Hemodialysis is usually performed in a clinic under the supervision of a nurse and kidney specialist, and is generally required three times a week for about 3 to 4 hours each time. For example, a Monday-Wednesday-Friday schedule or a Tuesday-Thursday-Saturday schedule is possible. In addition, a morning, afternoon, or evening shift will be dependant upon availability and capacity at the dialysis unit. Options for scheduling regular treatments will be discussed when the treatment begins.
Peritoneal Dialysis (PD)
The Procedure
In PD, a soft tube called a catheter is used to fill the abdominal cavity with a cleansing liquid called dialysis solution. The walls of the abdominal cavity are lined with a membrane called the peritoneum, which allows waste products and extra fluid to pass from your blood into the dialysis solution. The solution contains a sugar called dextrose that will pull wastes and extra fluid into the abdominal cavity. These wastes and fluid then leave the body when the dialysis solution is drained. The used solution, containing wastes and extra fluid, is then discarded. The process of draining and filling is called an "exchange," and takes about 30 to 40 minutes. The period the dialysis solution is in your abdomen is called the "dwell time." A typical schedule calls for four exchanges a day, each with a dwell time of 4 to 6 hours. Different types of PD have different schedules of daily exchanges.
Peritoneal dialysis can be performed in the home, usually while the child sleeps, without a health professional present. Training is available under this circumstance.
Alternative Forms of Peritoneal Dialysis
One form of PD, Continuous Ambulatory Peritoneal Dialysis (CAPD), doesn't require a machine. As the word ambulatory suggests, the patient can walk around with the dialysis solution in the abdomen. Another form of PD, Continuous Cycler-Assisted Peritoneal Dialysis (CCPD), requires a machine called a cycler to fill and drain the abdomen, usually while the patient is asleep. CCPD is also sometimes called Automated Peritoneal Dialysis (APD).
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