Considering Dialysis Treatment Options

Choosing the right dialysis treatment option for you can help you stay committed and feel your best. Planning ahead for the type of treatment you might choose is important. Know your options to help feel in control of your health if the time comes to make a decision.

Your care team can help

There are many types of dialysis to consider and options for treatment at home or in a dialysis center. Discuss your preferences with your nephrologist and your nurse to make sure you’re choosing the best treatment for you. Ask questions and share your thoughts. You may want to discuss things like:

• Your daily schedule
• Work or school obligations
• Other health conditions
• Social life
• Travel
• Care partner availability

Identify the best treatment option for you

Whether you choose an at-home or in-center dialysis option, you’ll receive a high level of care and attention. Once it is time to start dialysis, your nephrologist, or kidney doctor, will prescribe your treatment based on your personal health needs. 

At-home peritoneal dialysis (PD)

Where treatment happens: In the comfort of your own home

What treatment is like: Your blood is filtered using many tiny blood vessels in the lining of your abdomen (called the peritoneum).

Who performs the treatment: You—or with a care partner, if you prefer

Access type(s) for treatment: Peritoneal catheter—a flexible hollow tube surgically placed in the lower abdomen to allow fluid to enter and exit the peritoneal cavity.

Typical treatment schedule:
Session times vary based on the option you choose:

Continuous ambulatory peritoneal dialysis (CAPD)
3–5 times per day, 20–30 minutes per session, done manually

Automated peritoneal dialysis (APD)
6-10 hours overnight while you sleep, done automatically

Key considerations:

• You will see your dialysis team regularly (usually monthly) to monitor your labs and your dialysis prescription.
• It does not involve needles, and your blood never leaves your body.
• You can do PD without assistance.
• PD may help preserve residual kidney function.
• PD can be done almost anywhere—at work, at home, and while traveling.
• You may have more freedom with your diet and fluid intake compared to in-center hemodialysis.
• You have 24/7 access to a nurse who can help if issues or concerns arise.

At-home hemodialysis (HD)

Where treatment happens: In the comfort of your own home

What treatment is like: You are connected to an artificial kidney (dialyzer) via a needle in your access site. The dialyzer is designed for at-home use and is the size of a side table or nightstand.

Who performs the treatment: You—or with a care partner, depending on your therapy choice

Access type(s) for treatment:

• Fistula
• Graft
• Hemodialysis catheter, if medically necessary

Typical treatment schedule:
Frequency and duration can vary by person but may follow one of these options:

• 3 times a week, 3–5+ hours per session
• 5–6 times a week, 2.5–3 hours per session
• Overnight, 6–8 hours per session

Key considerations:

• You will see your dialysis team regularly (usually monthly) to monitor your labs and your dialysis prescription.
• You may be able to do at-home HD without assistance.
• You have more flexibility and can choose your treatment timing.
• You save travel time and transportation costs.
• You may have more freedom with your diet if you’re prescribed more frequent treatments.
• A nurse is available 24/7 by phone if you need assistance.

In-center hemodialysis

Where treatment happens: In the dialysis center

What treatment is like: You are connected to an artificial kidney (dialyzer) via a needle in your access site. Blood is filtered through the dialyzer and then returned to your body.

Who performs the treatment: A trained team of nurses and technicians. Some dialysis clinics also allow self-care, which means you can perform your treatment after some training.

Access type(s) for treatment:

• Fistula
• Graft
• Hemodialysis catheter, if medically necessary

Typical treatment schedule:
Frequency and duration can vary by person, but may follow one of these options:

• 3 times a week, 3–5 hours per session
• 3 nights a week, 8 hours per session—nocturnal (nighttime) in-center hemodialysis can be done while you sleep. Available at select dialysis centers only.

Key considerations:

• Treatment is performed and/or monitored by trained nurses and technicians, so you can relax.
• All treatments, labs, and checkups are done in the center.
• You can connect with other people sharing similar experiences at your center.

You can change your mind

Many people switch from one kind of dialysis to another, depending on changing lifestyle and health needs. If you choose one option and decide to change—you can! Your care team will be there to support you along the way.

Your care team can also answer your questions about treatment options other than dialysis, like getting a transplant or deciding to do supportive care.

We are here to help

We are here to support you along the way. Reach out if you have questions about your dialysis options.