Haemodialysis vs Peritoneal Dialysis: Difference and Comparison

Haemodialysis and Peritoneal Dialysis are two different types of dialysis. Dialysis is a treatment method by which patients suffering from kidney failure undergo cleansing of their blood. In haemodialysis, the cleansing of blood is done outside the body using an artificial machine. In peritoneal dialysis, a dialysate solution is injected into the inner lining of the patient’s abdomen, acting as a natural filter.

Key Takeaways

1. Haemodialysis uses a machine to filter waste products from the blood, while peritoneal dialysis uses the peritoneal membrane inside the abdomen.
2. Haemodialysis is performed in a healthcare facility, while peritoneal dialysis can be done at home.
3. Peritoneal dialysis allows for more flexible scheduling and continuous treatment, whereas hemodialysis requires multiple weekly sessions at fixed times.

Haemodialysis vs Peritoneal Dialysis

The difference between “Haemodialysis” and “Peritoneal Dialysis” is that in Haemodialysis, the cleansing of blood is done outside the body, while in Peritoneal Dialysis, the cleansing of blood is done inside the body itself with the aid of an external agent in the form of a dialysate solution.

Haemodialysis uses a man-made dialysis machine (called a dialyzer) which transfers blood from the body into the machine. This machine then cleans the blood and circulates it back into the body. It helps to remove excess fluids and other wastes from the patient’s body in case of kidney failure.

Peritoneal Dialysis uses the abdominal lining (or peritoneum) of a person’s body to cleanse the blood of waste and excess fluids/toxins. A peritoneal catheter is inserted into the peritoneum using surgical methods. This is used to fill the abdominal cavity with a special dialysate fluid which cleans the blood and collects the waste into an external collection bag for disposal.

Comparison Table

Parameters of Comparison	Haemodialysis	Peritoneal Dialysis
Internal/External	The cleansing of blood is carried out outside the body	The cleansing of blood is carried out inside the body
Duration	3 to 5 times a week generally	3 to 4 hours per day
Diet Restrictions	Diet restrictions are there, mainly regarding salt and water	Comparatively fewer diet restrictions
Major side effects	Fatigue, low/high BP, risk of heart diseases	Risk of infection from catheter
Site of performance	Either hospital or home	Mostly done at home
Movement	Restricts movement	Less restrictions in movements

What is Haemodialysis?

Haemodialysis is a type of dialysis in which a man-made machine, called a dialyzer, is responsible for performing the functions of a malfunctioning kidney. The machine uses vascular access to pull blood out of the body and into itself. This blood is then cleaned using specialized in-built filters within the machine, after which it is pumped back into the body.

This process can be either inpatient or outpatient in a hospital/clinic. It can also be performed at home with the assistance of a caregiver who must be trained to operate the machine. The process needs to be performed around 3 times a week in 3-5 hours sessions. Sometimes shorter sessions of 2 hours can be performed. But these need to be more frequent at around 6-7 days a week.

The main downside of the procedure is that while the process is going on, the person must be sitting or lying down, restricting movements and their daily schedules. Also, planning trips can be challenging as the patients need to make sure that such facilities are available where they are going.

Further, it requires observing higher dietary controls (like minimization of salt and water intake) that must be followed religiously. Major complications arising from the process can be low/high blood pressure, bone diseases, heart problems, muscle cramps, itching etc.

What is Peritoneal Dialysis?

Peritoneal dialysis is a type of dialysis in which the function of a malfunctioning kidney is performed through an abdominal membrane called the peritoneum. A liquid solution (or dialysate) is used for this purpose. It contains bicarbonates, sodium chloride and some osmotic agents like glucose.

In this process, a catheter is inserted into the person’s abdominal cavity through laparoscopic surgery. The dialysate is infused into the body using this catheter, and it helps remove excess fluids, toxins and other dissolved substances from the blood within the body using the peritoneum as a filter. Such waste is collected into an external collection bag for disposal.

It is comparatively a better alternative for people with significant cardiovascular problems. It also provides greater flexibility and movements as it can be performed at one’s own home, even at night. It also does not require very stringent dietary controls. The process can also be performed while travelling as long as a person takes the necessary precautions and ensures their surroundings are clean.

However, the downsides are that it must be performed daily and takes about 3-4 hours per day. Also, it may lead to a number of complications like abdominal infections due to the catheter, high blood sugar, abdominal bleeding, hernias etc.

Main Differences Between Haemodialysis and Peritoneal Dialysis

1. In haemodialysis, the cleansing of blood is performed outside the body using a dialyzer machine, whereas, in peritoneal dialysis, the peritoneum (or the abdominal cavity) acts as the filter for cleansing.
2. Haemodialysis must be carried out 3-5 times a week, whereas peritoneal dialysis must be carried out for 3-4 hours daily.
3. A person on haemodialysis has higher dietary restrictions (mainly related to water intake and salt), whereas a person on peritoneal dialysis faces fewer dietary restrictions.
4. Major side effects from haemodialysis can be fatigue, drop/rise in blood pressure, vascular problems etc. On the other hand, peritoneal dialysis’s biggest side effect is the infection risk from the catheter inserted into the abdominal cavity.
5. Haemodialysis can be performed at a hospital or at home with appropriate machinery, whereas peritoneal dialysis is performed at home with the help of a caregiver.
6. Haemodialysis requires patients to sit or lie down, thus restricting their movements and travel. Conversely, peritoneal dialysis can be performed at home during the night to lessen the restrictions on movement and can also be performed while travelling.