There are two main types of dialysis: haemodialysis and peritoneal dialysis. They work in different ways.

Haemodialysis

Before you first have haemodialysis, you’ll need minor surgery to create access to your bloodstream. This will be done in one of three ways:

Fistula – an artery and vein are joined together under your skin which can usually be used for many years.

Graft – a plastic tube is used to join an artery and vein under your skin which can usually be used for a few years.

Catheter – a flexible tube is put into a large vein in your neck or next to your groin which is usually used for a short time.

During haemodialysis, a tube is attached to a needle in your arm where the fistula or graft is located.

Blood passes along the tube into a dialysis machine (also known as a haemodialyser). 

The dialyser acts like an artificial kidney and filters out waste, salt and excess fluid in your blood. 

Your filtered blood is then passed through another tube and back into your body through a second needle in your arm.

Or if a catheter is used, your blood passes both into and back from the dialysis machine via this tube. 

Haemodialysis is usually carried out three or four days a week. Each session lasts around four hours.

Peritoneal dialysis

Peritoneal dialysis uses the inside lining of your belly (the peritoneum) to clean your blood, rather than a dialysis machine.

Like the kidneys, the peritoneum contains thousands of tiny blood vessels. This makes it a good filter.

Before you first have peritoneal dialysis, a cut is made near your belly button. A thin tube is inserted through the cut and into a space inside your belly (the peritoneal cavity). This is left in place permanently.

When you have peritoneal dialysis, a special dialysis fluid is pumped through the tube and into your peritoneal cavity. 

As blood passes through the blood vessels lining your peritoneal cavity, waste products and excess fluid are drawn out of the blood and into the dialysis fluid.

The used fluid is drained into a bag a few hours later and replaced with fresh fluid.

Changing the fluid usually takes about 30 minutes and normally needs to be repeated around four times a day.

For many people, haemodialysis and peritoneal dialysis are equally good treatments, with each having its own advantages and drawbacks.

Before you start kidney dialysis, your care team will discuss the pros and cons of each option with you to help you make the best decision.

Haemodialysis advantages

• Only required three to four days a week, leaving you with three or four days without dialysis.

Haemodialysis drawbacks

• Long treatment sessions required
• Need to make changes to what you eat and drink
• Need to take medication regularly
• May need to travel to a dialysis centre

Peritoneal dialysis advantages

• Can be done quite easily at home as well as at a hospital
• Can be sometimes done while you sleep
• Less expensive 

Peritoneal dialysis drawbacks

• Needs to be done every day
• Requires permanent catheter outside of your body

Depending on the type of dialysis you have, you may experience different side effects. We will discuss these with you before treatment.

Haemodialysis side effects

• Fatigue (tired or exhausted all the time)
• Itchy skin
• Muscle cramps
• Low blood pressure, leading to sickness and dizziness
• Greater risk of sepsis (blood poisoning)
• Sleep problems

Peritoneal dialysis side effects

• Fatigue (tired or exhausted all the time)
• Infection of the peritoneum (called peritonitis)
• Hernia (part of the abdominal contents pushing through the catheter entry site)
• Weight gain