What Is the Difference Between Hemodialysis and Dialysis?

Hemodialysis and peritoneal dialysis are different ways to filter the blood.

Dialysis is a procedure that helps your blood get filtered by a machine that works like an artificial kidney.

Based on the difference in techniques, there are two types of dialysis

• Hemodialysis: Your entire blood is circulated outside your body in a machine placed outside the body known as a dialyzer. This dialyzer acts like an artificial kidney that cleans and returns the blood to your body. This is done either at a dialysis facility or at home. The term dialysis generally refers to hemodialysis and there is no difference between these two terminologies.
• Peritoneal dialysis: Unlike hemodialysis that cleans the blood outside your body, peritoneal dialysis helps filter the blood in the body itself. This is done by allowing cleansing fluid to flow into the abdomen via a tube. The lining of the abdomen extracts the waste from the blood, and then, the fluid along with the wastes is drained out of the body.

A person whose kidney function has declined considerably needs hemodialysis. This happens when only 10% to 15% of the kidney function is left. This condition is known as kidney failure or end-stage renal disease (ESRD).

The common causes of kidney failure include

• Diabetes
• High blood pressure
• Autoimmune diseases, such as lupus and IgA nephropathy
• Polycystic kidney disease (a genetic condition in which multiple cysts develop in the kidney)
• Nephrotic syndrome

Kidney failure is diagnosed when certain tests, such as the kidney function tests, show abnormal levels. When your kidneys fail, the signs and symptoms that usually develop include

• Nausea and vomiting
• Muscle cramps
• Itching
• Loss of appetite
• Swelling in your feet and ankles
• Polyuria (too much urine) or oliguria (decreased urine output)
• Difficulty breathing
• Trouble sleeping

During hemodialysis, your blood is pumped to a machine known as ‘dialyzer’ that is placed outside the body. The pumping of blood takes place via a tube where one end is connected to the dialyzer and the other end goes into your arms or neck. The access into the body can be created in either of the following three ways 

• Fistula: This is a connection made between an artery and a vein in your arm.
• Graft: A soft tube joins an artery and a vein in your arm.
• Catheter: A soft tube is placed into a large vein of your neck.

The dialysis machine pumps the waste-filled blood through the filter and returns the clean (filtered) blood to your body. During the process, the dialysis machine checks your blood pressure and controls the speed of blood flow from your body and back into your body.

In a dialysis center, a single session of hemodialysis usually takes around 4 hours.

Hemodialysis is generally done three times per week on alternate days.

You can also do the dialysis procedure at home after getting adequate training from the nurse. While at home, dialysis treatment can be carried out as many as four to seven times a week for a shorter duration each time.

Hemodialysis may affect your routine life significantly because it takes a lot of your time. You need to make certain adjustments in your life when you have planned to go ahead with it. Here are a few of the changes that your doctor will generally advise you.

• Make changes to your diet
  • Limit foods and liquids that are rich in sodium, potassium and phosphorus.
  • Restrict liquid intake, including water intake, to 32 ounces in a day.
  • Eat a high-protein diet, especially one that has high-quality proteins, such as eggs, fish, meat and poultry.
  • Only take kidney-friendly vitamins.
• Take care of your access: You need to wash your dialysis entry site daily with soap and lukewarm water and take precautions so that it does not  get infected.

Have a discussion with your dialysis center’s dietician about which diet plan will work best for you. The right hemodialysis plan along with an appropriate diet can make your dialysis sessions much better.

Although it is a life-saving procedure, the possible problems that may arise due to hemodialysis include

• Infection of the access site
• Bleeding from the access site (if the tube comes out accidentally)
• Muscle cramps
• Weakness
• Dizziness

Do not hesitate to discuss any  apprehensions you may have regarding hemodialysis with your doctor. Your doctor will make adjustments to your dialysis machine or increase/decrease hemodialysis sessions, which may help resolve the complications.