Haemodialysis vs Peritoneal Dialysis?

Types of dialysis: Haemodialysis & peritoneal dialysis

There are 2 main types of dialysis: Haemodialysis and peritoneal dialysis. Both types of dialysis help remove toxins and excess fluids from the blood.

Haemodialysis vs Peritoneal Dialysis | Dr Francisco Salcido-Ochoa

So what is the key difference between haemodialysis and peritoneal dialysis?

The main difference lies on how the filtering process is done. 

Haemodialysis uses a kidney machine to clean the blood, while peritoneal dialysis uses the abdomen lining (the peritoneum) for the blood filtering process.

Choosing between the two types of dialysis treatments is based on the patient’s medical condition, lifestyle, and personal preference.

Renal Replacement Therapy: Hemodialysis vs Peritoneal Dialysis (video via Alila Medical Media)

How does haemodialysis work?

Haemodialysis treatment uses an artificial kidney machine to imitate the filtering function of a healthy kidney.

To prepare for haemodialysis, the patient will need a blood vessel called an arteriovenous fistula (AV fistula) created in the arm via a minor surgery. This blood vessel is created via the surgical connection between an artery to a vein, and makes it easier to transfer the blood into the dialysis machine and back into the body.
Arteriovenous Fistula

AV Fistula
Image source: https://en.wikipedia.org

The AV fistula surgery is usually carried out around 4 to 8 weeks before haemodialysis to allow the tissue and skin surrounding the fistula to heal.

A tube is attached to a needle in your arm to create the vascular access for the blood to go in and out during haemodialysis. 


What Happens During Haemodialysis
Image source: https://www.niddk.nih.gov

During haemodialysis, the blood is extracted and channelled into the artificial kidney machine via the soft tube, where the toxins and excess fluids are removed. 

The dialysis machine contains a series of membranes that act as filters and a special liquid called dialysate, which filter toxins and excess fluids from your blood, which are passed into the dialysate fluid.


Hemodialysis Dialyzer Illustration
Image source: https://www.niddk.nih.gov

This dialysate fluid is then pumped out of the dialyser, and the filtered blood is channelled back into your body via the second vascular access.

See the pros and cons of haemodialysis here.

How does peritoneal dialysis work?

Peritoneal dialysis uses the inner lining of the abdomen (the peritoneum) as a natural filter of the blood. 

Similar to the kidneys, our peritoneum contains thousands of tiny blood vessels that can help with the filtering function.

First, an incision (cut) is usually made just below your belly button to place a catheter (a thin tube) into the peritoneal cavity (the space inside the abdomen). This opening will normally be left to heal for a few weeks before treatment starts.

During the peritoneal dialysis, a bag of dialysis solution (dialysate) is pumped into the abdomen via the catheter and left there for a few hours. 

peritoneal dialysis illustration

Peritoneal Dialysis
Image source: https://nkfs.org

As blood passes through the blood vessels lining the peritoneal cavity, excess fluids and toxins are drawn out from the blood into the dialysis fluid.

The kidney patient is then free to move around and carry on with his/her activities for a few hours.

This dialysis fluid will absorb excess fluids and toxins from the blood, and is drained out via the catheter after a few hours into the waste bag. 

The new fluid from a fresh bag is then passed into your peritoneal cavity and left there until the next session.

Between treatment sessions, the end of the catheter is sealed and the bags are disconnected. 

See the pros and cons of peritoneal dialysis here.

Get Personalised Advice & Holistic Renal Treatment on Chronic Kidney Disease in Singapore

Battling the chronic kidney disease (CKD) can be a daunting and exhausting journey. And the treatments for CKD varies for everyone based on their medical history, current medical conditions, lifestyle and diet. That is why a personalised approach is crucial. If you need any advice on chronic kidney disease (CKD) from a kidney specialist in Singapore, feel free to reach out to Dr Francisco here.

Important information on chronic kidney disease

What is chronic kidney disease
Signs and symptoms of chronic kidney disease
Stages of chronic kidney disease
Treatments for chronic kidney disease patients
Renal diet for chronic kidney disease patients
Kidney dialysis for chronic kidney disease patients
Kidney transplantation for chronic kidney disease patients