Dialysis is a necessary treatment option to replace lost kidney function in people with kidney failure. Fortunately, there are many options that can make dialysis easier and more convenient.
Where you want to have treatment will affect the options available to you. Hemodialysis is the most common form of dialysis and can be done at home or in a dialysis center. Peritoneal dialysis is exclusively done at home. If you want to do hemodialysis at home, you will have more flexibility in your treatment options, but it will take longer to transition from a center to home treatments. Home hemodialysis requires several weeks of training. If you have a friend or loved one who will help you with treatments, they will also need to go through training. Otherwise, you may need to hire someone to help with home hemodialysis, such as a home health aid who is trained to work with dialysis patients.
Hemodialysis is often the easiest type of dialysis treatment option because it only requires venous access. To ensure you have continuous access to a blood vessel, you will need a minor surgery to create an arteriovenous fistula. Essentially, a connection is made between the artery and vein in your upper arm for the cannula to be inserted during dialysis. A cannula is used for dialysis since the blood is removed and returned at the same time. Peritoneal dialysis requires more intervention upfront, but may be easier in the long-term. A surgical procedure to insert a catheter into your peritoneal cavity will be necessary for you to connect your dialysis fluids. Once you have healed from the surgery, you will have a port in your abdomen where you connect the fluids during the exchange.
Both peritoneal dialysis and hemodialysis have some variations in the duration of each treatment session. With peritoneal dialysis, you may need to do exchanges multiple times per day, but each session may be short. As an alternative, you may choose an automated method. With automated peritoneal dialysis, you typically have longer treatment sessions while you sleep and may need another treatment during the day. If you choose hemodialysis, your options will depend on whether you are doing treatments at home or in the center. In rare cases, some centers might offer more flexibility in the duration of your treatments. Generally, treatments in a dialysis center are limited to three times per week, done on alternating days for approximately four hours. At home, you might choose overnight treatments done up to six nights each week, or daytime treatments six times per week for two to four hours. The standard four-hour treatments on alternating days are also an option for home hemodialysis.
Although the need for dialysis can seem limiting, there are many options to maintain your treatment plan and lead a full life.