The kidneys filter your blood by removing waste and excess fluid from your body. This waste is sent to the bladder to be eliminated when you urinate.
Dialysis performs the function of the kidneys if they’ve failed. According to the National Kidney Foundation, end-stage kidney failure occurs when the kidneys are performing at only 10 to 15 percent of their normal function.
Dialysis is a treatment that filters and purifies the blood using a machine. This helps keep your fluids and electrolytes in balance when the kidneys can’t do their job.
Dialysis has been used since the 1940s to treat people with kidney problems.
What are the different types of dialysis?
There are three different types of dialysis.
Hemodialysis is the most common type of dialysis. This process uses an artificial kidney (hemodialyzer) to remove waste and extra fluid from the blood. The blood is removed from the body and filtered through the artificial kidney. The filtered blood is then returned to the body with the help of a dialysis machine.
To get the blood to flow to the artificial kidney, your doctor will perform surgery to create an entrance point (vascular access) into your blood vessels. The three types of entrance points are:
- Arteriovenous (AV) fistula. This type connects an artery and a vein. It’s the preferred option.
- AV graft. This type is a looped tube.
- Vascular access catheter. This may be inserted into the large vein in your neck.
Both the AV fistula and AV graft are designed for long-term dialysis treatments. People who receive AV fistulas are healed and ready to begin hemodialysis two to three months after their surgery. People who receive AV grafts are ready in two to three weeks. Catheters are designed for short-term or temporary use.
Hemodialysis treatments usually last three to five hours and are performed three times per week. However, hemodialysis treatment can also be completed in shorter, more frequent sessions.
Most hemodialysis treatments are performed at a hospital, doctor’s office, or dialysis center. The length of treatment depends on your body size, the amount of waste in your body, and the current state of your health.
After you’ve been on hemodialysis for an extended period of time, your doctor may feel that you’re ready to give yourself dialysis treatments at home. This option is more common for people who need long-term treatment.
Peritoneal dialysis involves surgery to implant a peritoneal dialysis (PD) catheter into your abdomen. The catheter helps filter your blood through the peritoneum, a membrane in your abdomen. During treatment, a special fluid called dialysate flows into the peritoneum. The dialysate absorbs waste. Once the dialysate draws waste out of the bloodstream, it’s drained from your abdomen.
This process takes a few hours and needs to be repeated four to six times per day. However, the exchange of fluids can be performed while you’re sleeping or awake.
There are numerous different types of peritoneal dialysis. The main ones are:
- Continuous ambulatory peritoneal dialysis (CAPD). In CAPD, your abdomen is filled and drained multiple times each day. This method doesn’t require a machine and must be performed while awake.
- Continuous cycling peritoneal dialysis (CCPD). CCPD uses a machine to cycle the fluid in and out of your abdomen. It’s usually done at night while you sleep.
- Intermittent peritoneal dialysis (IPD). This treatment is usually performed in the hospital, though it may be performed at home. It uses the same machine as CCPD, but the process takes longer.
Continuous renal replacement therapy (CRRT)
This therapy is used primarily in the intensive care unit for people with acute kidney failure. It’s also known as hemofiltration. A machine passes the blood through tubing. A filter then removes waste products and water. The blood is returned to the body, along with replacement fluid. This procedure is performed 12 to 24 hours a day, generally every day.
Alternatives of Dialysis
Dialysis is time-consuming and expensive. Not everyone chooses it, particularly if they’re experiencing severe, acute kidney failure.
If you decide not to pursue dialysis, there are other treatment options that may help manage your symptoms. One of these options is anemia management. When the kidneys are working properly, the hormone erythropoietin (EPO) is produced naturally in the body. To help with an under-functioning kidney, you can get an injection of EPO every week.
Maintaining good blood pressure can help slow the deterioration of your kidney. Drink fluids to avoid dehydration. Talk to your doctor before taking any anti-inflammatory drugs, including ibuprofen (Advil) and diclofenac (Solaraze, Voltaren).
A kidney transplant is another option for some people. It’s also a long-term commitment. Talk to your doctor to see if a transplant is right for you. You might not be a good candidate for a kidney transplant if you:
- heavily use alcohol
- are obese
- have an untreated mental health condition