Difference Between Haemodialysis and Peritoneal Dialysis

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, cleansing of blood is done outside the body using an artificial machine. In peritoneal dialysis, a dialysate solution is injected into the inside lining of the patient’s abdomen which then acts as a natural filter.

Haemodialysis vs Peritoneal Dialysis

The difference between “Haemodialysis” and “Peritoneal Dialysis” is that in Haemodialysis cleansing of blood is done outside the body while in Peritoneal Dialysis, 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 failures.

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 Between Haemodialysis and Peritoneal Dialysis

Parameters of ComparisonHaemodialysisPeritoneal Dialysis
Internal/ExternalThe cleansing of blood is carried out outside the bodyThe cleansing of blood is carried out inside the body
Duration3 to 5 times a week generally3 to 4 hours per day
Diet RestrictionsDiet restrictions are there, mainly regarding salt and waterComparatively fewer diet restrictions
Major side effectsFatigue, low/high BP, risk of heart diseasesRisk of infection from catheter
Site of performanceEither hospital or homeMostly done at home
MovementRestricts movementLess restrictions in movements

What is Haemodialysis?

Haemodialysis is a type of dialysis in which a man-made machine, called dialyzer, is responsible for performing the functions of a malfunctioning kidney. The machine uses a 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 generally 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 needs to be sitting or lying down, which restricts 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 observation of higher dietary controls (like minimization of salt and water intake) that need to 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 peritoneum. A liquid solution (or dialysate) is used for the purpose. It typically 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 removed 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 needs to be performed daily and takes up 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, 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 needs to be carried out 3-5 times a week, whereas peritoneal dialysis needs to 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, the biggest side effect for peritoneal dialysis is the risk of infection 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 generally performed at home with the help of a caregiver.
  6. Haemodialysis requires patients to be sitting or lying down and thus restricts 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.

Conclusion

Haemodialysis and peritoneal dialysis, both are types of dialysis procedures that help filter out the wastes from a person’s body who is suffering from kidney failure and thus, is unable to do so naturally.

Haemodialysis is an external process whose effects last for a comparatively longer period of time. Peritoneal dialysis is an internal body process which has to be carried out daily.

To sum up, the main difference between these two types of dialysis is that haemodialysis cleanses the blood of fluids, discharges and toxins in a specialized equipment outside the body, while peritoneal dialysis does the same within the body itself.

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