Difference Between Hemodialysis and Peritoneal Dialysis

 Key Difference: In hemodialysis, blood is pumped out of your body to an artificial kidney machine, and returned to your body by tubes that connect you to the machine. In peritoneal dialysis, the inside lining of your own belly acts as a natural filter. Wastes are taken out by means of a cleansing fluid called dialysate, which is washed in and out of your belly in cycles.

The two primary treatment options for patients with end-stage renal disease are hemodialysis and peritoneal dialysis.

According to National Kidney Foundation “Dialysis is a way of cleaning your blood when your kidneys can no longer do the job. It gets rid of your body's wastes, extra salt and water, and helps to control your blood pressure.”

Hemodialysis

“Hemodialysis is a process of purifying the blood of a person whose kidneys are not working normally. This type of dialysis achieves the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of kidney failure.”

HemodialysisHemodialysis can be an outpatient or inpatient therapy. Routine hemodialysis is conducted in a dialysis outpatient facility, either a purpose-built room in a hospital or a dedicated, stand-alone clinic. Less frequently hemodialysis is done at home. Dialysis treatments in a clinic are initiated and managed by specialized staff made up of nurses and technicians; dialysis treatments at home can be self-initiated and managed or done jointly with the assistance of a trained helper who is usually a family member.

Disadvantages

  • Restricts independence, as people undergoing this procedure cannot travel around because of supplies' availability.
  • Requires more supplies such as high-water quality and electricity.
  • Requires reliable technology like dialysis machines.
  • The procedure is complicated and requires that care givers have more knowledge.
  • Requires time to set up and clean dialysis machines, and expense with machines and associated staff.

     

Peritoneal Dialysis

“Peritoneal dialysis is a type of dialysis which uses the peritoneum in a person's abdomen as the membrane through which fluid and dissolved substances are exchanged with the blood. It is used to remove excess fluid, correct electrolyte problems, and remove toxins in those with kidney failure.”Peritoneal Dialysis

In peritoneal dialysis, a specific solution is introduced through a permanent tube in the lower abdomen and then removed. This may either occur at regular intervals throughout the day, known as continuous ambulatory dialysis, or at night with the assistance of a machine, known as automated peritoneal dialysis. The solution is typically made of sodium chloride, hydrogen carbonate, and an osmotic agent such as glucose.

Disadvantages

  • Infections can be as frequent as once every 15 months (0.8 episodes per patient year).
  • Complications may include infections within the abdomen, hernias, high blood sugar, bleeding in the abdomen, and blockage of the catheter. Use is not possible in those with significant prior abdominal surgery or inflammatory bowel disease.

Compared to hemodialysis, peritoneal allows greater patient mobility, produces fewer swings in symptoms due to its continuous nature and phosphate compounds are better removed, but large amounts of albumin are removed which requires constant monitoring of nutritional status. The costs of peritoneal dialysis are generally lower than that of hemodialysis in most parts of the world, this cost advantage is most apparent in developed economies.

Peritoneal dialysis may also be used for patients with cardiac instability as it does not result in rapid and significant alterations to body fluids, and for patients with insulin-dependent diabetes mellitus due to the inability to control blood sugar levels through the catheter.

 

Hemodialysis

Peritoneal Dialysis

Definition

In hemodialysis, blood is pumped out of your body to an artificial kidney machine, and returned to your body by tubes that connect you to the machine.

 In peritoneal dialysis, the inside lining of your own belly acts as a natural filter. Wastes are taken out by means of a cleansing fluid called dialysate, which is washed in and out of your belly in cycles.

 

Patient Mobility

Lesser pateient mobility.

Allows greater patient mobility.

Swings in symptoms

More swings as compared to peritoneal dialysis.

Produces fewer swings in symptoms due to its continuous nature.

Removal

Phosphate is not removed so effectively but albumin loss is lesser.

Phosphate compounds are better removed, but large amounts of albumin are removed.

Cost Effective

Less cost effective.

More cost effective.

References: kidney.org,wikipedia.org( hemodialysis and peritoneal dialysis)
Image Courtesy: kidshealth.org,nurseslabs.com

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