[Dialysis in end-stage kidney disease]

Abstract

Available treatment options for patients with end-stage kidney disease are kidney transplantation, haemodialysis, peritoneal dialysis or refraining from renal replacement therapy (conservative treatment). Haemodialysis removes uremic toxins and fluid by passing blood via vascular access through an artificial kidney for 4 hours 3 times a week on average. Peritoneal dialysis (PD) removes uremic toxins and fluid through the peritoneum by instillation and drainage of a special fluid via a PD catheter in and out of the abdominal cavity a number of times a day. Peritoneal dialysis is performed at home, while haemodialysis is performed at a hospital or dialysis centre, but can also be performed at home. Both forms of dialysis have significant impact on patients' quality of life and each have their own specific complications. These are mainly problems with vascular access and intradialytic hypotension in the case of haemodialysis, while the occurrence of peritonitis and membrane failure are those of peritoneal dialysis.