Kidney Korner: Types of Renal Replacement

A common misconception about dialysis is that you live life bound to a clinic and a chair. However, that is far from true. There is life on dialysis and we want to help you keep living it. There are four (4)  types of renal replacement: in-center hemodialysis, home hemodialysis, peritoneal dialysis and transplantation. Today, we will discuss the pros and cons of each to help you begin making the decision that best fits your needs. 

In-Center Hemodialysis
In-center hemodialysis is the modality that most people think of when it comes to dialysis. This type of dialysis is done in a clinic setting 3 days a week for a few hours at a time. These schedules vary from person to person based on their dialysis prescription. Hemodialysis uses a fistula or graft to access veins and arteries. 

• Pros: monitoring by team of professionals, no care partner needed, usually three (3) treatment per week, no equipment or supplies at home, regular contact with care team and other patients for support
  
• Cons: required to be in-center for treatment (approx. 4 hours per day, 3 days per week), may feel more tired or worn down due to less treatment, restricted diet, increased discomfort,  insertion of needles for treatment, permanent access to your blood (usually in the arm) 
  

Home Hemodialysis
Home hemodialysis is completed at home on a daily basis, using a permanent access to the blood, typically in your arm. Based on your needs and circumstances, this can be a fistula or a graft.  Home hemodialysis is performed 4-6 times per week.

• Pros: Dialyze on your schedule and in the comfort of your own home, less restricted diet, may require fewer medications
  
• Cons: Requires a trained care partner, space for supplies at home, insertion of needles for treatment
  

Peritoneal Dialysis
Peritoneal dialysis is unique in that it uses the peritoneum, or the lining of the abdomen, to act as a kidney and filter out the toxins and waste from the blood. This type of dialysis can be done at home or other sterile settings to complete the exchange. Peritoneal dialysis is done daily.

• Pros: dialyze on your schedule and in the comfort of your own home, no needles or blood needed, flexibility with diet and schedule, easier to travel
  
• Cons: Requires training for the patient, space for supplies at home, higher risk of infection, permanent catheter, may have weight gain/larger waistline
  

Kidney Transplant
While it is not dialysis, kidney transplantation is a form of renal replacement that should always be considered and discussed. When you receive a kidney transplant, the donor kidney is placed in the front, lower abdomen. The patient’s own kidneys are not removed. 

• Pros: Off of dialysis, closest to having your own kidneys, fewer fluid and diet restrictions, may feel healthier and have more energy, “normal” lifestyle
  
• Cons: Risk of rejection, specific criteria must be met for health status, potentially long wait on transplant list, increased susceptibility to infection, daily medications required, risks associated with major surgery
  

As you can see, there are benefits and draw-backs to each of these options. You should always discuss your options with your nephrologist and/or dialysis care team to make sure you are choosing the path that best fits your lifestyle and needs. One option may work for some but not for others, and that’s okay.

Our fabulous care team at DialySuites would be more than happy to help guide you in finding your best fit. Call today to learn more about DialySuites and your options! (904) 618-3131

​