Dialysis Techniques: Understanding Your Treatment Options

Chronic kidney disease may require a replacement therapy to partially take over the role of your kidneys. Today, two main dialysis techniques are available: hemodialysis and peritoneal dialysis. This guide helps you understand how each method works, the devices used, and what to expect during treatment.

1. What is the purpose of dialysis?

Dialysis helps to:

• Remove toxins and excess fluid from your body
• Restore the balance of minerals and water
• Improve appetite and overall well-being
• Support an active social and daily life

However, dialysis also comes with certain commitments, including regular sessions, medical supervision, and a carefully managed diet (limiting salt, water, potassium, and phosphorus).

2. When should dialysis begin?

Dialysis is usually considered when:

• Symptoms become difficult to manage, such as fatigue, nausea, loss of appetite, swelling, or shortness of breath
• Glomerular filtration rate drops below 15 ml/min/1.73 m²
• Blood levels of urea and creatinine are too high

3. Choosing the right dialysis technique

Your choice depends on your health, lifestyle, personal preferences, and medical feasibility. This decision is made together with your nephrologist after providing clear, detailed information. In some cases, switching from one method to another may be possible.

4. Hemodialysis: How it works

Hemodialysis filters your blood using a machine called a dialyzer. Blood circulates outside the body, passes through a membrane that removes waste and excess water, and is then returned to your bloodstream.

To perform hemodialysis, a vascular access point is needed—a site where blood can be safely removed and returned.

5. Peritoneal Dialysis: A home-based alternative

Peritoneal dialysis uses your own peritoneum (a natural membrane in your abdomen) to filter blood. Sterile dialysis fluid, called dialysate, is introduced into the abdomen via a peritoneal catheter, allowing waste products and excess fluid to be removed.

Peritoneal catheter
The catheter is inserted under local or general anesthesia. Flexible and discreet, it partially exits the abdomen and is securely fixed to prevent movement or dislodgement. It has a built-in one-way valve and an internal system to reduce infection risk. Between sessions, it should be protected with a sterile, waterproof dressing.

6. Supportive treatments and care

Hygiene and diet
A tailored diet and hygiene routine improve treatment effectiveness and reduce complications. Your nephrologist will provide personalized guidance.

Blood transfusions
May be required to manage anemia. You will be fully informed, and consent will be obtained.

Vaccinations
Regular monitoring of your vaccinations is performed, including systematic hepatitis B vaccination and regular hepatitis C screening (no vaccine available for hepatitis C).

Laboratory tests
Whenever possible, tests are done during dialysis sessions to minimize additional needle sticks.

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