Chronic Kidney Disease (cont.)
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Hemodialysis involves circulation of blood through a filter or dialyzer on a dialysis machine.
Hemodialysis may be done in a dialysis center or at home. In-center hemodialysis typically takes 3 to 5 hours and is performed three times a week. The patient will need to travel to a dialysis center for in-center hemodialysis.
Some centers may offer the option of nocturnal (night-time) hemodialysis wherein the therapy is delivered while the patient sleeps. Long nocturnal dialysis offers patients a better survival and an improvement in their quality of life.
Home hemodialysis is possible in some situations. A care partner is needed to assist the patient with the dialysis treatments. A family member or close friends are the usual options, though occasionally people may hire a professional to assist with dialysis. Home hemodialysis may be performed as traditional three times a week treatments, long nocturnal (overnight) hemodialysis, or short daily hemodialysis. Daily hemodialysis and long nocturnal hemodialysis offer advantages in quality of life and better control of high blood pressure, anemia, and bone disease.
Peritoneal dialysis utilizes the lining membrane (peritoneum) of the abdomen as a filter to clean blood and remove excess fluid. Peritoneal dialysis may be performed manually (continuous ambulatory peritoneal dialysis) or by using a machine to perform the dialysis at night (automated peritoneal dialysis).
Most patients are candidates for both hemodialysis and peritoneal dialysis. There are little differences in outcomes between the two procedures. The physician may recommend one kind of dialysis over the other based on the patient's medical and surgical history. It is best to choose one's modality of dialysis after understanding both procedures and matching them to one's lifestyle, daily activities, schedule, distance from the dialysis unit, support system, and personal preference.
Pranay Kathuria, MD, FACP, FASN, FNKF
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