Pros and cons - Dialysis

If dialysis is recommended for you, you'll often be able to choose whether to have haemodialysis or peritoneal dialysis.

Both methods of dialysis are equally effective for most people, so it's usually a case of personal preference.

But there may be some situations where a particular type of dialysis is best.

For example, peritoneal dialysis may be recommended for:

• children aged 2 or younger
• people who still have some limited kidney function
• adults who do not have other serious health conditions, such as heart disease or cancer

Haemodialysis may be recommended for people who are unable to carry out peritoneal dialysis themselves, such as those who are visually impaired, have dementia, or are in a poor state of health.

Any decision you make about which procedure to have will not be final. It's possible to move from one to the other.

Haemodialysis

An advantage of haemodialysis is that you have 4 dialysis-free days a week.

The procedure in a dialysis centre usually involves using a dialysis machine 3 times a week, with each session usually lasting about 4 hours. You'll need to plan your life around these sessions.

As the sessions are carried out in a dialysis clinic, you may need to travel regularly for treatment. But it may be possible to be trained how to use the equipment at home.

With home haemodialysis you can choose when and where to have dialysis sessions. You may also be able to have dialysis overnight. This may help you to have a normal routine and travel with the machine.

If you're having treatment in a dialysis centre and you travel to another country, you'll have to arrange access to dialysis facilities beforehand. 

Inform the staff at your dialysis centre well in advance, as they may be able to arrange for you to be referred to a dialysis unit at your destination.

The Global Dialysis website has a database of dialysis units across the world, but these units may charge a fee.

Another disadvantage of haemodialysis is that your diet and the amount of fluid you drink needs to be restricted. 

Many people receiving haemodialysis in a dialysis centre have to avoid certain foods and are usually advised not to drink more than a couple of cups of fluid a day.

However, evidence suggests that having more regular dialysis sessions at home can help you have fewer dietary and fluid restrictions.

Read about the side effects of haemodialysis

Peritoneal dialysis

Unlike haemodialysis, an advantage of peritoneal dialysis is that regular visits to a dialysis unit are not required, and it can be carried out at home.

There are also fewer restrictions on diet and fluid intake for people having peritoneal dialysis, compared with those having haemodialysis.

One of the main disadvantages of peritoneal dialysis is that it needs to be carried out every day, which you may find disruptive.

You may also find it upsetting to have a thin tube (catheter) left permanently in your abdomen (tummy), although it can often be concealed under clothing.

Another major disadvantage of peritoneal dialysis is that you're at risk of developing peritonitis, an infection of the thin membrane that lines your abdomen.

In rare cases, your peritoneum may gradually become thickened and scarred. Some people may need to switch to haemodialysis after a few years to stop this happening.

Another drawback of peritoneal dialysis is that the dialysis fluid used can cause a reduction in protein levels, which can lead to a lack of energy and, in some cases, malnutrition.

Weight gain is also a possible side effect.

Read about the side effects of peritoneal dialysis

Continuous versus automated peritoneal dialysis

If you choose to have peritoneal dialysis, you'll have to decide whether you want to have continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD).

Read about how peritoneal dialysis is performed for more information about these procedures.

The main advantage of CAPD is that the equipment is portable. This gives you more freedom to travel away from your house.

For example, you may be able to take your CAPD equipment to your workplace. But you'll need to spend at least 2 hours a day performing dialysis.

The main advantage of using APD is that your days are dialysis-free. But you need to keep and maintain a dialysis machine (and the associated equipment) in your house, which will not be practical for some people.