My therapy options
Which therapy option is right for me?
Your physician has discussed with you that your kidney function is severely impaired and that you will need to select a renal replacement therapy (RRT) option that is most suitable for you soon, to preserve both your life and quality of life. As there is more than one option available for therapy for many patients, it is important that you take the opportunity to learn more about your therapy options to make the right choice for you personally.
Choosing the right therapy for kidney failure may be difficult. Become familiar with the therapy options and, together with your physician, choose the therapy that best suits your health status and lifestyle.
Supporting you on your way
We would like to support you on your path to the right therapy and have compiled the most important information about different therapy options.
- With some tips that support choosing the right therapy, we will provide you some guidance on the way to making a decision
- We want to introduce to you the most important therapy options: transplantation, peritoneal dialysis, hemodialysis, home hemodialysis and conservative therapy
- The dialysis therapy you chose is not set in stone…
- Dialysis changes your everyday life. In the section My life with dialysis, we address the most relevant topics for choosing a therapy option: everyday life, exercising, vacation and nutrition
Peritoneal dialysis (PD)
Continuous ambulatory peritoneal dialysis (CAPD)
How to perform a bag exchange step-by-step
The dialysis solution is passed through the catheter into the abdominal cavity.
The dialysis solution remains in the abdominal cavity for several hours. Waste products and excess body water are absorbed by dialysis.
After a predetermined time, the dialysis solution is drained from the abdominal cavity and replaced with fresh solution.
Automated peritoneal dialysis (APD)
Learn about peritoneal dialysis in the following video:
During a hemodialysis treatment, your blood is filtered outside of your body through a dialyzer, also called a filter or artificial kidney, to remove unwanted waste, toxins, and excess body fluids. For the treatment, a specific access to the blood stream (vascular access) needs to be created that is used to access your blood vessels during treatment. There are three main vascular access types: a fistula, graft, or catheter. A surgeon will create this access, usually in the arm or sometimes in the leg, if it is a fistula or a graft. Catheters are generally inserted into the vessels in your neck. The preferred access for HD is a fistula, which is an access in the arm made by joining your vein and artery in a small surgical procedure and has been shown to have better outcomes compared to a graft or a catheter.
Hemodialysis uses a solution called dialysate to remove unwanted substances from your blood. Different from peritoneal dialysis, there is a special man-made membrane in the dialyzer that allows the cleaning of the blood. This restores your body and provides chemically balanced blood which is then returned to your body.
A typical hemodialysis treatment takes four to five hours and is repeated three times a week. However, the timing, duration and frequency of hemodialysis depend on your medical conditions and lifestyle as well as your insurance coverage.
If you choose in-center dialysis, you usually have three fixed appointments per week. With this treatment option, the dialysis team will prepare, carry out and monitor the dialysis for you.
Dialysis in a center
Learn about hemodialysis in the following video:
Make a choice
1 Mucsi I, Hercz G, Uldall R, Ouwendyk M, Francoeur R, Pierratos A. Control of serum phosphate without any phosphate binders in patients treated with nocturnal hemodialysis. Kidney Int. 1998;53(5):1399-1404. doi:10.1046/j.1523-1755.1998.00875.x
2 Culleton BF, Walsh M, Klarenbach SW, et al. Effect of frequent nocturnal hemodialysis vs conventional hemodialysis on left ventricular mass and quality of life: a randomized controlled trial. JAMA. 2007;298(11):1291-1299. doi:10.1001/jama.298.11.1291
3 Chan CT, Shen SX, Picton P, Floras J. Nocturnal home hemodialysis improved baroreflex effectiveness index of end-stagerenal disease patients. J Hypertens. 2008; 26(9):1795-1800. doi: 10.1097/HJH.0b013e328308b7c8
4 Marshall MR, Polkinghorne KR, Kerr PG, Hawley CM, Agar JW, McDonald SP. Intensive Hemodialysis and Mortality Risk in Australian and New Zealand Populations. Am J Kidney Dis. 2016;67(4):617-628. doi:10.1053/j.ajkd.2015.09.025
5 Rydell H, Ivarsson K, Almquist M, Segelmark M, Clyne N. Improved long-term survival with home hemodialysis compared with institutional hemodialysis and peritoneal dialysis: a matched cohort study. BMC Nephrol. 2019;20(1):52. Published 2019 Feb 13. doi:10.1186/s12882-019-1245-x
6 Marshall MR, Walker RC, Polkinghorne KR, Lynn KL. Survival on home dialysis in New Zealand. PLoS One. 2014;9(5):e96847. Published 2014 May 7. doi:10.1371/ journal.pone.0096847
Thank you for your feedback.