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


If you have chronic kidney disease, there are several types of dialysis that may be right for you. In general, dialysis is designed to perform similar functions that your kidney can no longer do effectively on its own. This means removing toxins and wastes from your bloodstream, maintaining your body’s chemical balance, and preventing extra water from accumulating in your body.

There are two main types of home dialysis treatment: home hemodialysis (HHD) and peritoneal dialysis (PD).

Home Hemodialysis (HHD)

Home hemodialysis, or HHD, uses a smaller dialysis machine that can be set up in the comfort of your home. Like in-center hemodialysis, HHD filters your blood outside of the body. Before beginning treatment, a surgeon will make a vascular access which will allow blood to get to the dialyzer. During the treatment, blood leaves your body through tubes and enters the dialysis machine, where it is filtered. The filtered blood then returns to the body.

Depending on your schedule and needs, HHD is performed more frequently in sessions that may range from 3 to 6 hours. Standard HHD can be done on the days and times of your choosing, so long as you do not go more than 2 consecutive days without treatment. Alternately, daily HHD treatments may be easier to fit into your day. These last between 2.5 and 4 hours for 5 or 6 days a week. With daily treatments, you may have even fewer dietary restrictions.

Longer HHD sessions can be performed at night. This treatment method takes about 8 hours and is called nocturnal hemodialysis (NHD). It may take some time to adjust to sleeping with the machine on, but there will be alarms to wake you up if so much as a single drop of blood leaks overnight. Having your days free from treatment is benefit for many people using NHD.

Peritoneal Dialysis (PD) 

Another type of home treatment is peritoneal dialysis (PD). Unlike HHD, this dialysis method uses your own peritoneal membrane as the filter. The peritoneal membrane is a semipermeable sac that contains your abdominal organs. This means waste particles can pass through the membrane, but not large blood cells.

PD does not involve using any needles. Instead, a synthetic tube called a peritoneal catheter is surgically placed in the abdominal cavity. Once the catheter is implanted, you’ll be able to slowly empty dialysate fluid through the catheter. The dialysate fluid enters the body, is attracts wastes and impurities to pass through the semipermeable peritoneal membrane. After several hours, you’ll drain the dialysate over the course of about 30 minutes. This process, called Continuous Ambulatory Peritoneal Dialysis (CAPD), is repeated about five times each day and can be done in any clean environment.

Peritoneal dialysis can also be performed at overnight. Called Continuous Cycling Peritoneal Dialysis (CCPD), this process is facilitated by a machine that measures and warms dialysate for you while you sleep. CCPD takes approximately 10 continuous hours to complete, leaving you free from daytime treatments.

Which Treatment is Right for Me?

Determining which home dialysis treatment method is right for you will be a collaborative effort between you and your Cincinnati Home Dialysis kidney care team. Talk to your team about your lifestyle goals, diet, and schedule preferences. Together, we will find the treatment that suits your lifestyle.

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