Choosing a Treatment Type
Dialysis or Transplantation – You Have Options
There are different ways to dialyze. One of them might be a good fit for your lifestyle and medical situation right now or in the future. Getting a transplant is also an option. A brief introduction to each treatment type or modality follows. Your care team should be advising you on which options are possible given your medical situation, educating you on the pluses and minuses of each modality, and helping you make an informed choice. While you can change modality later, if your medical situation isn't an emergency and you have time to make the best choice before you begin dialysis or plan your transplant, you won't regret it.
Hemodialysis (HD) involves removal of waste products, electrolytes, and fluid from your blood at a dialysis center using a machine that pumps your blood through an artificial kidney called a dialyzer. Before you can do Hemodialysis a surgeon must place one of several kinds of ports into your body, in order to get frequent access to your blood.
In-center hemodialysis (ICH) – Usually done 3 times a week but some facilities offer nocturnal and daily schedules. This option allows you to interact with others on dialysis.
Conventional home hemodialysis (HHD) – Requires you and a helper to undergo training. Done 3 times a week at home. Benefits include a flexible schedule and fewer trips to the clinic.
Daily home hemodialysis – Also requires training for yourself and a helper. Involves shorter treatment time, performed 5-7 days a week. More dialysis is better for your health.
Nocturnal home hemodialysis – You and a helper train to do your treatments at home, 3-6 nights a week. This frees your days, and allows fewer trips to the clinic.
Peritoneal dialysis (PD) uses the inner lining of your abdomen (the peritoneum) as a dialysis filter. The peritoneum is lined with tiny blood vessels. Wastes and extra water in your blood can flow out of those blood vessels, through the peritoneum, and into special fluid that you put into your abdomen. Then you drain the fluid and the wastes out of your body and put in clean fluid (this is called an exchange). To do PD, a surgeon places a soft plastic tube called a PD catheter into your abdomen. PD requires no needles, and patients have less diet restrictions.
Continuous ambulatory PD (CAPD) – A manual form of PD, with no machine. This option is flexible and adapts to your schedule.
Continuous cycling PD (CCPD) – A form of PD using a machine called a cycler at night while you sleep. This option allows you to have your days free.
Transplantation is when they put someone else's kidney into your body. You can get by with only one. While the donor's body has to match yours on a number of medical criteria, your care team should be able to help you find a living donor that matches, and get you on the list to find a matching kidney from a deceased donor in the interim. Get everybody you know to sign up to be an organ donor. If you and your team can find a donor, you can go straight to transplant without having to do dialysis.
Transplantation Selection Criteria for transplant centers within the Network.
Page updated January 9, 2015