Peritoneal Dialysis vs. Hemodialysis: Which One Is Right for You?

Peritoneal Dialysis vs. Hemodialysis: Which One Is Right for You?
      Kidneys play a vital role in filtering waste and maintaining the body’s fluid balance. When the kidneys can no longer function properly, excess fluid and toxins accumulate, affecting multiple body systems and potentially becoming life-threatening. Dialysis is one treatment method that helps support kidney function, allowing the body to operate more normally and prolonging patients' lives.

When should patients with chronic kidney disease start dialysis?
      Most doctors recommend that patients with chronic kidney disease start planning for dialysis when they reach stage 4, especially if their kidney filtration rate continues to decline. Dialysis is often necessary within six months at this stage.

Currently, there are two main types of dialysis :
1. Hemodialysis (through a blood vessel using a dialysis machine)
2. Peritoneal Dialysis (through the abdominal cavity)

Hemodialysis
      This method involves removing the patient’s blood through a vein, filtering it through a dialysis machine to remove waste, and then returning the clean blood to the body.

Benefits of Hemodialysis

• Effectively removes medium- and large-molecule waste
• Reduces toxin buildup efficiently
• Lower risk of infection due to being performed in a hospital setting under professional supervision
• Patients can maintain daily activities (e.g., bathing, swimming)
• Helps stabilize cardiovascular functions in patients with heart or blood pressure conditions

Limitations of Hemodialysis

• Requires hospital visits 3–4 times a week, which may disrupt daily life
• Does not provide continuous waste removal like peritoneal dialysis
• Requires stricter fluid and dietary control to prevent toxin buildup
• May cause visibly bulging veins or blocked vessels used for dialysis

Peritoneal Dialysis (CAPD: Continuous Ambulatory Peritoneal Dialysis)
      This method involves surgically placing a permanent catheter into the abdominal cavity, allowing dialysis fluid to be exchanged in and out through the catheter.

Benefits of Peritoneal Dialysis

• No need to visit the hospital—can be done at home
• Greater dietary flexibility due to daily toxin removal (3–4 times a day)
• Option to use an automated machine (APD) for convenience and less daily disruption

Limitations of Peritoneal Dialysis

• Must be performed every day (3–4 times/day for CAPD), which may be inconvenient
• Higher risk of infection if hygiene is not maintained
• Requires follow-up with a doctor every 1–2 weeks
• Patients must live with a catheter in the abdomen, which may feel uncomfortable
• Not suitable for everyone (e.g., patients with weak or abnormal abdominal walls, those with a history of abdominal surgery, lung or intestinal issues, or kidney cysts)

      For patients with chronic or end-stage kidney disease, dialysis is a supportive treatment that helps improve quality of life. Choosing the right method should be based on a physician’s recommendation and tailored to each patient’s condition and lifestyle. Ratchasima Hospital offers a dialysis center with specialized nephrologists and nurses ready to care for patients under all healthcare schemes.

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