Dialysis: What Patients Need to Know

Dialysis is a treatment that does the filtering work your kidneys can no longer do. There are two main types: haemodialysis, which filters blood through a machine (usually at a dialysis centre, three times a week), and peritoneal dialysis, which uses the lining of your abdomen as a filter and is done at home daily. Both remove waste products and excess fluid to keep you alive and functioning.

Neither is universally better — they suit different lifestyles and medical situations. Haemodialysis typically means three sessions a week of around four hours at a centre; peritoneal dialysis is done daily at home, either overnight (APD) or as multiple bag exchanges during the day (CAPD). Studies show comparable outcomes on average. The right choice depends on your home setup, work schedule, vascular access, and personal priorities.

In-centre haemodialysis is most commonly three sessions per week, roughly four hours each. Some patients do home haemodialysis more frequently (short daily or nocturnal). Peritoneal dialysis is daily — either several manual exchanges during the day or automated overnight via a machine while you sleep.

There is no single threshold. Many patients start dialysis when their eGFR falls below 10–15 and they develop symptoms of kidney failure such as fatigue, nausea, fluid overload, or uncontrolled electrolytes. Some start earlier, some later. The decision is guided by symptoms and lab trends, not just the eGFR number.

Many patients continue to work, travel, exercise, and maintain rich family lives on dialysis. It requires planning and energy management, and the treatment schedule does shape your week, but it is far from a life on pause. Peritoneal dialysis and home haemodialysis offer more flexibility; in-centre HD is more scheduled but also removes the logistics of home treatment.