Hemodialysis and Peritoneal Dialysis: The Two Options
Dialysis does some of the work of failing kidneys by removing waste, salt and excess fluid. There are two main types. Hemodialysis cleans the blood outside the body using a machine, usually at a centre two to three times a week. Peritoneal dialysis cleans the blood inside the body using the lining of the abdomen, and can often be done at home. The choice is not simply a patient preference — it depends on medical suitability, home circumstances, and the support available.
Hemodialysis
Blood is drawn out, passed through a filter (dialyser) that removes waste and fluid, and returned. Sessions typically last about four hours, three times a week, at a hospital or dialysis unit. It requires reliable vascular access, usually a fistula created in the arm.
Peritoneal dialysis
A special fluid is placed into the abdomen through a soft tube. The lining of the abdomen filters waste into the fluid, which is then drained. It can be done as manual exchanges during the day or automatically overnight. It suits people who want to manage treatment at home and can follow a sterile technique.
How the decision is actually made
This is a medical decision, not a lifestyle preference alone. Your nephrologist considers residual kidney function, your abdomen's suitability for peritoneal dialysis, your home and support situation, and your own priorities. Many people move between modalities over time.
Common questions
Can I do dialysis at home?
Peritoneal dialysis is commonly done at home. Home hemodialysis exists in some centres but is less widespread. Ask your nephrologist what is available where you are treated.
Which type of dialysis is better?
Neither is uniformly better. Each suits different medical and personal situations, and many patients switch between them over the course of their treatment.
Sources
- KDIGO Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease — Kidney Disease: Improving Global Outcomes (KDIGO)
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