When kidney function falls to around 10–15% (kidney failure), the body can no longer remove enough waste and fluid on its own. Dialysis takes over that job. There are two main types, and the best choice depends on your health, lifestyle and preferences.
The two main types of dialysis
Hemodialysis (HD)
Blood is gently pumped through a machine with an artificial filter and returned to the body. Usually done 3 times a week, about 4 hours per session, at a dialysis centre (or at home in some programmes).
Peritoneal Dialysis (PD)
Uses the lining of your own abdomen as a natural filter. A cleansing fluid flows in and out through a soft tube. It is done at home, daily, and offers more independence and flexibility.
What does a session feel like?
During hemodialysis you sit or recline comfortably — many people read, watch shows, or nap. Two needles connect your access (usually an AV fistula in the arm) to the machine. Most sessions are painless, though some feel tired afterwards. Peritoneal dialysis is needle-free and can often be done overnight while you sleep.
A look inside a hemodialysis session.
Diet and fluid on dialysis
Because dialysis only partly replaces kidney function, what you eat and drink between sessions matters. Your dietitian will personalise your plan, but common themes are:
- Fluid limits to avoid excess fluid building up between sessions
- Potassium and phosphorus control to protect your heart and bones
- Adequate protein, as dialysis removes some protein (especially in PD)
- Lower salt, which also helps control thirst
Protect your access
Your fistula or catheter is your lifeline. Keep it clean, avoid blood-pressure cuffs or blood draws on a fistula arm, and report redness, swelling or reduced "buzz" (thrill) immediately.
Can I still travel and work?
Yes. Many people on dialysis continue working and take holidays — hemodialysis units worldwide accept visiting patients, and home PD supplies can be delivered to your destination. Planning ahead with your team makes it smooth.
Dialysis is one option, not the only one
For suitable patients, a kidney transplant offers the best long-term quality of life. Ask your nephrologist whether transplant assessment is right for you — see our transplant guide.
References & Further Reading
- National Kidney Foundation. "Dialysis." kidney.org
- NIDDK, National Institutes of Health. "Kidney Failure: Choosing a Treatment." niddk.nih.gov
- National Kidney Foundation. "Hemodialysis" and "Peritoneal Dialysis." kidney.org
This article is for general education only and does not replace personalised medical advice. Your dialysis plan should be guided by your nephrology team.