For some patients, lifestyle concerns are paramount

Dialysis modality selection can be a difficult decision for patients. Once basic clinical needs have been met, lifestyle concerns may be the next most important care aspect to address.  

With In-center Hemodialysis (HD), patients follow a weekly set schedule that can impact their time, but also provide an opportunity to socialize with other End-Stage Renal Disease (ESRD) patients. Home therapies, like Peritoneal Dialysis (PD), can provide patients more flexible scheduling to work full-time, attend school or travel while also allowing them to dialyze at home closer to family.  

Each patient has different lifestyle needs, and fortunately, there are treatment options available to help them find the right modality for their unique situation.


More frequent, daily dialysis and longer treatment times can provide additional clinical benefits

While some patients may do better with the weekly In-center HD routine, larger patients and those with high ultrafiltration requirements may have more difficultly with intermittent dialysis.1 Daily dialysis may help patients feel better through consistent removal of fluids and toxins, as opposed to intermittent in-center dialysis that can result in greater fatigue between sessions. Both PD and Home HD can be prescribed daily.  


Home therapies can be less restrictive and less intrusive

While all dialysis modalities require dietary restrictions, some home therapies may be easier to follow for some patients. For example, the PD diet does not require reduced potassium intake, but does require additional protein than the HD diet.

The management of prescriptions for all ESRD patients can be daunting, especially when they are dealing with comorbidities. But reliance on some ESRD-specific medications may be eased with PD. PD patients have lower Erythropoietin utilization,2 as they do not routinely lose blood as often as HD patients do.

Dialysis can be a life changing experience for many patients, and some may feel as though they have lost all semblance of a normal life. Home therapies may help some patients deal with these changes a little more easily. According to the BOLDE study, using the Illness Intrusion Ratings Scale (IIRS), a tool that assesses the impact of chronic illness and its treatment on 13 patient quality of life measures, PD patients find their illness and/or treatment less intrusive in relation to their health and diet than HD patients.3  However, new-to-dialysis patients may see no difference in modality intrusion; for patients dialyzing less than one year, there was no significant difference between PD and HD in the IIRS evaluation.3

*The following are online resources from professional associations, government entities, and consumer organizations that provide more information. Baxter Healthcare Corporation does not review or control the content of any non-Baxter site. Baxter Healthcare Corporation does not endorse and is not responsible for the accuracy, content, practices or standards of any non-Baxter sources.

1 Diaz-Buxo J, Crawford-Bonadio T. Major Difficulties the US Nephrologist Faces in Providing Adequate Dialysis. Blood Purif. 2007;25:48-52.
USRDS 2008 Annual Data Report: Atlas of End-Stage Renal Disease in the United States, Vol. 2, 2008; 1-264, U.S. Renal Data System.

Brown, Edwina A, Johansson, Lina, et al. Broadening Options for Long-term Dialysis in the Elderly (BOLDE): differences in quality of life on peritoneal dialysis compared to haemodialysis for older patients. Nephrol Dial Transplant. 2010;10.1093/ndt/gf212.

Daily dialysis can help patients feel better.

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