What’s the Difference between Home Peritoneal Dialysis and Home Hemodialysis?

If you’re considering home dialysis, it’s important to understand the difference between home peritoneal dialysis (PD) and home hemodialysis (HD). Knowing the difference between these dialysis options can help you choose one that’s right for you, your family, and your lifestyle.

Home peritoneal dialysis uses the lining on the inside of the belly, called your peritoneum, as a natural filter for blood. During home PD, dialysate fluid is placed in your peritoneal cavity using a peritoneal catheter—either manually or by using a machine called a cycler. This process is called filling.

The fluid stays in your peritoneum for a period of called, “dwell time,” while the dialysate absorbs the waste, toxins, and excess fluid from your blood. When the dialysate is drained from your peritoneal cavity, the waste, toxins, and excess fluid are removed along with it. The completion of this peritoneal dialysis procedure—filling, dwelling, and draining—is called an exchange.

Home PD is designed to be done daily, and as a result can be a gentler treatment since this option acts more closely to the natural around-the-clock function of a kidney. Your doctor will work with you to create the right dialysis schedule for you.

Home HD filters your blood outside of your body through a dialyzer or “artificial kidney machine” to remove unwanted waste, toxins, and excess fluids. Your blood travels through plastic tubing to the dialyzer, where it is cleaned using a solution called dialysate to get rid of these unwanted substances. Clean, chemically balanced blood is then returned to your body.

Home HD requires a permanent access site called a fistula or graft to remove your blood and return the clean blood.

Both home PD and home HD offer the option of more frequent dialysis, as ordered by your physician, which can mean lower risk of health complications, feeling better, and having more energy to do the things you love. Both options may also mean fewer food restrictions and medications.

One of the major benefits of both home PD and home HD is that treatment can be done from the comfort of your own home, with or without a care partner, giving you more freedom, flexibility, and control over your schedule.

Whether you choose home PD or home HD, you will receive training so that you feel confident performing treatment at home. Your care team will also help you set up your home for treatment and order the supplies you need.

Even though you’re home, you’re not alone with either treatment choice. You’ll have 24/7 telephone access to on-call home nurses. That means you get the benefits of being at home and the comfort of knowing help is there if you need it. You’ll also be able manage your kidney health in collaboration with your care team using the PatientHub.

One difference between these treatment options is that home HD requires an artificial kidney machine to filter blood while home PD does not, although it may require a cycling machine. Home PD also does not require direct access to blood, so you will not need needles to complete a treatment. If you choose home HD and are worried about needles, your care team will provide support and guidance to help you through the process.

Some people may find that one option is a better fit. For example, people with a history of frequent abdominal surgeries may not be able to do home PD so may choose home HD.

As you learn more about home dialysis, talk with your care team and family about these options and if one might be a good choice for your treatment journey. Together, you and your doctor can decide which option best fits your lifestyle and needs so you can thrive.