Peritoneal dialysis and hemodialysis which method is better

Kidney disease experts believe, peritoneal dialysis and hemodialysis are an effective way to treat uremia, treatment can make patients get proper long-term survival, both can also be used as treatment for renal transplantation transition to.

Clinically, peritoneal dialysis and hemodialysis which method is better? This question is not complicated. The following points are required to make a choice in patients with primary consideration to the issue.

Treatment: strengths and weaknesses

For therapeutic effect, peritoneal dialysis and hemodialysis different. The purpose of dialysis is to remove the body of toxic substances, in general, hemodialysis effect of small molecular weight toxins better than peritoneal dialysis, but peritoneal dialysis to clear toxic effect of high molecular weight is better than hemodialysis.

To uremia stage, many patients decreased urine output, if sufficient water is not clear, there will be a lot of water accumulated in the body, causing edema, heart enlargement and hypertension.

Hemodialysis is generally 2 to 3 times a week, on the day of dialysis, according to how much water can accumulate in the body, and the body of excess water removed, but in non-dialysis days, due to the small amount of urine, can not intake too more moisture. Peritoneal dialysis can clear water every day, more balanced, so the water intake by relatively few restrictions. But there is a minority of patients with peritoneal dialysis poor clear water effects.

When comparing the two: dominant PD

Compared with hemodialysis, peritoneal dialysis has many advantages, such as peritoneal dialysis generally does not induce or aggravate arrhythmias, hypotension cause or aggravate cardiac ischemia, and hemodialysis due to the short time to have more blood into CPB and dehydration faster, more prone to low blood pressure and cardiac ischemia. Peritoneal dialysis patients with fewer antihypertensive drugs to control blood pressure for better results, it can be more secure, better maintain water, electrolyte and acid-base balance.

Opportunity hemodialysis patients with blood-borne infectious diseases greatly increased, especially hepatitis B and hepatitis C, and peritoneal dialysis is basically not cause blood-borne infectious diseases.

To uremia stage, although must dialysis, renal function is not equal to zero but the rest of the kidney function although rarely, but they are extremely important for quality of life and long-term prognosis, protect the residual renal function is important. One of the outstanding advantages of peritoneal dialysis is the impact on residual renal function in hemodialysis relatively small.

Acceptance of peritoneal dialysis patients with chronic renal failure anemia often are relatively mild, it is because, unlike hemodialysis, as peritoneal dialysis, each dialysis are more or less lost some blood, dialysis may also be more blood removed toxic substances inhibiting erythropoiesis.

Peritoneal dialysis can be done at home, away from the dialysis center for residence and live in nursing home patients, peritoneal dialysis is more convenient compared with hemodialysis. Compared with hemodialysis, peritoneal dialysis medical costs are relatively low.

Experts believe that although peritoneal dialysis have more advantages, but it also has drawbacks. The following main points:

The first is abdominal infections, also known as peritonitis. Although the vast majority of peritonitis can be cured in the short term, but fever, pain patients will cause pain, more protein and other nutrients are lost from the abdominal cavity peritonitis occurs. With the improvement of dialysis devices and sterilization methods, peritoneal infection rate has dropped significantly, with an average of 3 years occurs once.

Secondly, many patients that peritoneal dialysis is relatively less convenient, who always have tubes, bathing and activities is not easy, but to do several times a day. Some patients also believe there is nothing inconvenient peritoneal dialysis can be performed at home, and can be adjusted according to their needs. Many dialysis patients well, a few years do not need to be hospitalized.

The third obvious drawback is carried out with the dialysis, the remaining kidney function less and less body fat than those toxins may be insufficient to clear.

Normal peritoneal dialysis, dependent on a relatively normal abdominal wall, peritoneum and abdominal cavity, therefore, abdominal organs trauma, major abdominal surgery early, fecal fistula or colostomy, peritoneal drain, diaphragmatic leak, intra-abdominal cancer, inflammatory merger or ischemic bowel disease who diverticulitis in patients with recurrent abdominal wall or skin infection focus, abdominal exist mechanical defects (such as surgical repair of abdominal hernia can not, gastroschisis, etc.), previous surgery so that the loss of peritoneal function or extensive peritoneal adhesions, are not preferred dialysis.

Furthermore, since the intra-abdominal pressure increases peritoneal dialysis, so there is a serious and lumbosacral disc disease who have severe lung disease with pulmonary insufficiency who should choose carefully.

Choose dialysis: based prescription

Hemodialysis and peritoneal dialysis are effective methods of treatment for end-stage renal failure, for the vast majority of end-stage patients, can choose hemodialysis, peritoneal dialysis can also choose, but for some patients, which in some way may choose more as appropriate, before making a decision, Professor Wang believes that patients should be carefully asked the doctor to make the best choice.

Must be clear, peritoneal dialysis and hemodialysis are not contradictory, the first use of peritoneal dialysis who, after years of dialysis, peritoneal dialysis is not satisfactory or if you do not want to do peritoneal dialysis, hemodialysis can be changed, first use of Hemodialysis, After dialysis a few years, if you want to dialysis, it is relatively easy.

For ready to be kidney transplant patients, during the transition phase, two ways are possible, according to our experience, the transition phase as a treatment for peritoneal dialysis may be more appropriate.



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