Difference between Hemodialysis and Peritoneal Dialysis

February 13, 2017 by Editorial Team

Hemodialysis and peritoneal dialysis are medical options used to treat end-stage renal disease. Despite their similarities, they are far from being alike. This article explains the marked differences between these two medical terms.

Definitions

Hemodialysis vs Peritoneal Dialysis

Hemodialysis, also known as dialysis or kidney dialysis, is a medical procedure used to purify the blood by the use of a dialyzer, a machine that functions as an “artificial kidney”. The end-goal of the purification process is to restore the electrolyte balance within the body despite the kidney’s inability to function optimally.

A treatment option for people suffering from kidney failure, hemodialysis removes excess fluid and waste products such as urea, free water, and creatinine from the bloodstream. It can either be an inpatient or an outpatient treatment option.

Peritoneal dialysis

Peritoneal dialysis is also used to treat kidney failure. In this procedure, the tissues in the patient’s abdominal cavity are used to filter the blood and remove excess fluids and waste products. This dialysis technique aims to correct electrolyte imbalance by getting rid of toxins from the bloodstream.

During the procedure, a dialysis catheter is surgically inserted into the abdominal cavity, where a special fluid is flushed to wash and cleanse the intestines. After a specific period of time, the fluid containing waste products is removed from the peritoneal cavity.

Typically, the solution used during the process is a mixture of hydrogen carbonate, chloride, sodium, and an osmotic agent. The intestinal walls function as a filter between the bloodstream and this special solution.

Hemodialysis vs Peritoneal Dialysis

So what’s the difference between hemodialysis and peritoneal dialysis? While both these medical procedures have the same end-goal, they greatly differ in a number of ways.

Firstly, hemodialysis uses a dialyzer, a man-made membrane that removes excess fluids and waste products to filter the bloodstream. Peritoneal dialysis, on the other hand, uses the peritoneal membrane (the lining of the abdominal cavity) of the patient, along with a dialysate (a cleansing agent) to achieve the same end-result.

Before hemodialysis initiates, a registered physician needs to create an insertion site to facilitate unimpeded blood flow in and out of the body. The ideal access sites include the right interior jugular vein, the right external jugular vein, the left interior jugular vein, or the left external jugular vein. Meanwhile, during a peritoneal dialysis, an access is created to the patient’s abdominal cavity.

In relation to this, hemodialysis requires needle insertion to a vein since the dialyzer is connected to the body through tubes attached to the patient’s blood vessels. Contrary to this, peritoneal dialysis does not require needle insertion since the cleansing agent is introduced into the abdominal cavity through a dialysis catheter.

In terms of length and frequency, a hemodialysis procedure lasts for approximately 3 hours. It is typically done three times a week, depending on the physician’s prescription. Peritoneal dialysis, on the other hand, is called an “exchange.” A patient undergoing this treatment is recommended to complete around 4 to 6 exchanges a day.

Additionally, hemodialysis usually requires assistance from a professional healthcare provider, while peritoneal dialysis promotes independence as it can be done by the patient alone. Plus, since machinery is used for hemodialysis, it is more challenging to set it up at home.

Lastly, in terms of risks, hemodialysis makes a patient more vulnerable to bloodstream infection, while peritoneal dialysis heightens a patient’s risk for peritonitis, an infection of the lining of the abdominal cavity.

Comparison Chart

HemodialysisPeritoneal Dialysis
A medical procedure used to purify the blood by the use of a dialyzerUses the patient’s peritoneal membrane, along with a cleansing agent, to purify the blood
Ideal access sites: right interior jugular vein, the right external jugular vein, the left interior jugular vein or the left external jugular veinAccess site: abdominal cavity
Requires needle insertionRequires dialysis catheter insertion
Frequency: ideally, thrice a weekFrequency: ideally, 4 to 6 exchanges a day
Requires professional assistanceCan be done independently
Increased risk for bloodstream infectionIncreased risk for peritonitis