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5 types of home dialysis

There are five different ways (modalities) to do dialysis at home, and one of them might be a good fit for your lifestyle and needs—either right now, or in the future. With new equipment and technology breakthroughs, it's easier than ever to get high-quality dialysis at home.

What is dialysis?

Dialysis is a treatment for kidney failure that removes waste and extra fluid from the blood, using a filter. In peritoneal dialysis (PD), the filter is the lining of the abdomen, called the peritoneum. In hemodialysis (HD), the filter is a plastic tube filled with millions of hollow fibers, called a dialyzer.

Dialysis modalities

Each of the five modalities of dialysis offers different things—and you must choose the one that's right for you. We've outlined each modality below, and created a comparison chart to show the pluses and minuses of each modality so you can be sure you are choosing the best match.

Modality comparison chart

We've developed this chart to show the pluses and minuses for each of the five modalities and in-center hemodialysis so you can weigh your options.

Modality comparison: pluses
CAPD CCPD Conventional HHD Daily HHD Nocturnal HHD In-center HD
Less restrictive diet and fluids * * * * *
More dialysis to feel better * * * * *
Work-friendly treatment * * * * *
Puts you in charge * * * * *
You're not around sick people * * * * *
Fewer ups & downs * * * *
Days off between treatments * * *
Portable - take it with you * *
Flexible - suits your schedule * * * *
Available in every state * * *
Needle-free treatments * * *±
Have your days free * *
Learn it in a week or two * * *
Fistula likely to last longer * * *
Modality comparison: minuses
CAPD CCPD Conventional HHD Daily HHD Nocturnal HHD In-center HD
Time needed to receive supplies * * * * *
Need to visit clinic 3 times a week *
Supply storage space needed * * * *§ *
Infection is a risk * * * * * *
Can affect body image * * * * * *
Weight gain from dialysate * *
Limits swimming, tub bathing * * *± *±
Lack of privacy *
A partner is needed * * *
Takes several weeks of training * * *
Plumbing/wiring may be needed * * *
Limited availability * * *
Clinics lose money on it * *

± If dialyzing with a catheter
§ Depends on machine

Daily therapy study results compared

Daily therapy study results compared*
Study Hospitalization Reduction EPO Usage Reduction Blood Pressure Medication Reduction Patient Quality of Life Patient Employment
Buoncristiani et. al. (Perugia, IT; 83-present)
  • 76 patients
  • Short (1 hour)
  • Center-based
 Not reported 43% (hematocrit levels increased by 16%) 65% (with 20% reduction in mean BP)
  • Hypotension, cramps, headaches, fatigue 1/10 rate of control group
  • Greatly improved nutrition
 Not reported
Uldall/Pierratos (Toronto, ON; 94-present)
  • 50 patients
  • Long (nightly)
  • Home
 Not reported 40% (hematocrit levels increased by 15%) 67%
  • QOL improvement (SF-36, Sickness Impact Profile, Beck Depression Index)
  • Nutrition, weight gains
  • Sleep, cognitive, cardiac function gains
 11 of 23 working-age but unemployed patients returned to full-time work while on therapy
Ting (Mountain View, CA; 96-present)
  • 30 patients
  • Short (2 hours)
  • Center-based
 30% 55% (hematocrit levels increased by 7.5%) 50%
  • 21 of 30 QOL indicators improved (significant on the SF-36 and KD-QOL)
  • Nutrition, weight gains
 Not reported
Lockridge (Lynchburg, VA; 97-present) 67% 25% 75% (phosphate binders eliminated) QOL improvement (SF-36) Of working-age (18-58) patients, 3 of 5 returned to full-time work
Project HOPE
  • Recent meta-analysis of multiple published studies
 62% 41% 49% Statistically significant findings from multiple studies Snyder 12-patient study in Brooklyn, NY, reported a 50% return to work

* Information provided by Dr. Christopher Blagg.

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