Dialysis Options for Patients and Families

Important information about the kidneys and dialysis:

The kidneys have an important job: they make urine to remove waste from the body. They also:

• Control how much fluid the body removes.

• Help regulate blood pressure.

• Keep the balance of electrolytes, like potassium and sodium, in the blood.

• Help the body make vitamin D.

• Help bone marrow produce red blood cells.

If the kidneys can't do their job, dialysis may be needed. Dialysis is a treatment that takes over the work of the kidneys. It doesn’t cure kidney failure but helps manage it. Most children use dialysis until they can have a kidney transplant.

Types of dialysis

1. Hemodialysis (HD): Cleans the blood outside the body using a machine with a special filter. It can be done in the hospital or at home.

2. Peritoneal Dialysis (PD): Uses the lining of the belly (peritoneal space) as a natural filter to clean blood inside the body.

Peritoneal dialysis

Advantages:

• It is gentle and usually well-tolerated.

• There’s a lower risk of bloodstream infections because the blood stays inside the body (no catheter or fistula).

• Children can spend more time at home and school.

• Fewer diet and fluid restrictions compared to HD.

Disadvantages:

• There’s a risk of infection in the belly lining (peritonitis), which may require hospital care.

• Caregivers must commit to doing treatments every night.

• No days off from treatment.

• Learning to perform PD takes significant time and effort for caregivers in the beginning.

• The home needs enough storage space for monthly supplies and a clean environment to perform PD safely.

Hemodialysis

Advantages: 

• It is the most efficient dialysis option.

• Treatments take less time than peritoneal dialysis (PD).

• Removes fluid from the body more precisely.

• Nurses give the treatment.

• Medications like Epogen® or Aranesp® (to treat anemia) are given through the machine, avoiding injections.

Disadvantages:

• There’s a risk of bloodstream infections (sepsis) because blood is filtered outside the body.

• Some patients experience low blood pressure during treatment, which can cause headaches, dizziness, cramps, or nausea.

• You might feel tired or “washed out” after a session.

• If fluid restrictions aren’t followed, treatment may be needed more than three times a week.

• If using a fistula, two needles must be placed at the start of each session and removed at the end.

Home hemodialysis

Advantages:

• Allows more time at home and school.

• Fewer restrictions on diet and fluids compared to in-center hemodialysis.

• Treatments are shorter than peritoneal dialysis.

• Medications like Epogen® or Aranesp® are given through the machine, avoiding injections.

Disadvantages:

• There’s a risk of bloodstream infections (sepsis) because blood is filtered outside the body.

• Caregivers must commit to significant training (4 to 5 weeks at a dialysis center) to learn home hemodialysis in the beginning.

• The home needs enough storage space for monthly supplies and a clean environment for treatments.

• Caregivers must commit to performing every treatment at home.

Learn more: https://info.chop.edu/4hpQyBV