Dialysis is recommended when your kidney function declines to 15% or less, or when you are experiencing persistent symptoms such as fatigue, excessive sleepiness, nausea/vomiting, confusion, muscle cramping, tremors, loss of appetite, weight loss, and itchiness. You and your nephrologist should collaborate in making the decision of when to start dialysis.
There are two major types of dialysis: hemodialysis and peritoneal dialysis.
-Hemodialysis can be accomplished by self-administration in your home, or by traveling regularly to a dialysis unit (center-based hemodialysis).
-Peritoneal dialysis is always done by you in your home. There are two different types: one that utilizes a machine that assists you as you sleep, while the other involves manual administration by you typically four of five times a day.
Hemodialysis is a treatment option that stands in for the function of healthy kidneys by removing wastes and excess fluid from your blood. It is important to understand that hemodialysis is not a cure for kidney disease, nor does it improve the function of your kidneys. During hemodialysis, a machine circulates your blood through a filter surrounded by a special fluid.
In-Center You can do hemodialysis at a dialysis center where a nurse or technician performs the tasks required during treatment. In-center hemodialysis is usually done three times a week for about three to four hours each session.
At home You can also do hemodialysis at home by administering the treatment yourself. Hemodialysis at home affords you more flexibility in your schedule and allows you to better fit treatments into your daily schedule. Studies show that the more you know about your treatment and the more you do on your own, the better you are likely to do on dialysis.
Peritoneal Dialysis (PD) is a needle-free dialysis treatment option that best replicates your natural kidney function. PD offers more flexibility by allowing patients to dialyze from the comfort of their own home, at work, and even on vacation. PD can be performed at home two different ways: use of in a cycler machine at night, or manual dialysis during the day.
Continuous Cycling Peritoneal Dialysis (CCPD), also referred to as automated peritoneal dialysis (APD), requires a cycler machine to automate the process of filling and draining dialysate in your abdomen. CCPD is a popular choice because it allows most of your dialysis to be performed at night, which frees up the day for work, school, or other activities. The cycler is programmed to perform three to five fluid exchanges while you sleep, usually over a time period eight to ten hours long. Cycler machines are also small enough to be set on your bedside table. Most people get used to sleeping while on a cycler rather quickly and have few problems.
Continuous ambulatory peritoneal dialysis (CAPD) With CAPD, you can perform your dialysis exchanges manually without a machine. Exchanges, or the act of removing toxins and buildup in the body, can take approximately 30 minutes, and are generally performed four or five times during the day by placing a bag of dialysate fluid on an IV pole. Gravity then makes the filling and draining process possible. This form of PD can even be done while you’re at work, as long as you have a clean environment to perform the exchanges.
It’s important to find out which type of home dialysis will suit you best, peritoneal dialysis (PD) or home hemodialysis (Home HD). If the most suitable option of dialysis is chosen, the impact on you will be less. If you’re making the decision to start dialysis, you may want to answer these questions: