Hemodialysis uses a machine to clean your blood. The dialysis machine has a filter called a hemodialyzer or dialyzer. The dialyzer works like an artificial kidney and removes the wastes and the extra fluid that builds up when your kidneys are not working. Hemodialysis can’t do all the work your kidneys did. Healthy kidneys work all day,everyday. Hemodialysis usually occurs three times a week for about four hours each time. Your time is based on your needs. Your kidney doctor (Nephrologist) orders the length of your treatment in order to help meet your body’s needs.
Peritoneal Dialysis (PD)
Peritoneal dialysis (PD) uses the space in your belly called the peritoneal cavity to clean your blood. PD does not use a dialyzer. This space is lined with a membrane called the peritoneum. It surrounds and protects your intestines, bowel, and other organs. The membrane has many tiny holes that can be used to filter waste out of your blood while keeping blood cells and proteins in your vessels.
PD usually works all day, every day. To have PD you must have an access, which is a soft, flexible tube, called a catheter, surgically placed in your belly. The bottom part of the tube is put into the peritoneal cavity. The middle part of the tube runs under your skin. The top part stays outside of your body and can be taped against your skin.
There are two kinds of PD:
1. Continuous Ambulatory Peritoneal Dialysis (CAPD) or;
2. Continuous Cycling Peritoneal Dialysis (CCPD), sometimes called Automated Peritoneal Dialysis (APD).
Nocturnal Hemodialysis (ND)
Nocturnal Hemodialysis is a slow, gentle treatment that is done at night while you sleep; your days are free for work or other activities. The facility provides the machine for you. It shortens the time between treatments and the longer treatments allow less waste and fluid to build up between sessions. Nocturnal hemodialysis is easier on the heart than standard treatments and often allows for a more normal diet and fewer fluid limits and medications. Most people do nocturnal hemodialysis every other day, for eight hours.
Hemodialysis is typically conducted in a dedicated facility with specialized nurses and technicians who specialize in hemodialysis. However, dialysis can also be done in a patient’s home. Once you and your doctor have determined that at home hemodialysis is right for you, you will begin a comprehensive safety and training program that is tailored to your specific medical and learning needs. In most cases, you will learn to perform at home hemodialysis treatments with a dialysis partner.
There are three types of at-home hemodialysis:
1. Short Daily at Home Hemodialysis – Performed five or six times a week, typically for two to three hours per session.
2. Traditional at Home Hemodialysis – Performed three times per week, typically for about four hours per session. This is similar to the treatments received at a local dialysis center.
3. Nocturnal/Extended Home Hemodialysis – Performed during sleep, typically six to eight hours a night, three or more nights a week. Many patients enjoy the ability to spend the night dialyzing and not lose time during the day that could be spent at work or with family.