End-Stage Kidney Disease Is Not Something to Fear

Dialysis, Peritoneal Dialysis, and Kidney Transplantation Can Help You Start a New Life

When kidney function (remaining kidney function) declines to a score of about 5 to 10, patients may develop uremic symptoms such as loss of appetite, nausea, vomiting, itchy skin, swelling of the face and limbs, bad breath, and shortness of breath. At this stage, dialysis is required to improve symptoms and quality of life. Dialysis refers to the use of an artificial or the body’s own semi-permeable membrane to remove toxins and excess fluid from the blood, restoring it to a balanced state.

Hemodialysis (“Blood Dialysis”)

Commonly known as “dialysis” or “blood washing,” hemodialysis uses a machine to circulate the patient’s blood through an artificial kidney, filtering out waste products and excess water. Patients usually need to visit a dialysis center three times per week, with each session lasting about four hours.

Patients choosing hemodialysis must, depending on their vascular condition, have an arteriovenous fistula created at least one month in advance, or an artificial graft placed about two weeks before dialysis begins, so needles can be inserted during treatment. For patients who require emergency dialysis, physicians may place a temporary dialysis catheter to quickly relieve severe uremic symptoms.

Peritoneal Dialysis (“Abdominal Dialysis”)

Peritoneal dialysis involves surgically placing a catheter into the abdomen and infusing sterile dialysis solution into the abdominal cavity. The body’s natural membrane—the peritoneum—acts as a semi-permeable membrane to remove excess water and metabolic waste.

Patients do not need to go to a dialysis center. They can perform 3–5 exchanges per day at home or another suitable location. Each exchange takes about 20–30 minutes. During each exchange, used dialysis fluid containing waste is drained out, fresh solution is infused, and it remains in the abdomen for 4–6 hours before the next exchange. During this time, patients can work, attend school, do housework, or go shopping. Patients choosing peritoneal dialysis must first undergo surgery to place a peritoneal dialysis catheter.

How Should Patients Choose the Right Dialysis Method?

Patients and their families can decide based on the patient’s physical condition, home environment, ability for self-care, and family support system. Overall, peritoneal dialysis is more economical and convenient, avoids repeated needle sticks, can be performed at home, and better preserves residual kidney function (including urine output).

Peritoneal dialysis is especially suitable for students, working individuals, patients planning for future kidney transplantation, or those with limited mobility who have caregivers at home. If a patient has poor self-care ability and family members cannot assist with dialysis exchanges, hemodialysis is another appropriate option.

Kidney Transplantation (“Kidney Replacement”)

Kidney transplantation, also known as “kidney replacement,” does not involve removing the patient’s original kidneys. Instead, a donor kidney is surgically placed in the patient’s abdomen to take over kidney function. After transplantation, patients must take anti-rejection medications, but they can avoid the inconvenience of dialysis. Kidney transplantation offers a high survival rate and significantly improves quality of life.

If you have questions about hemodialysis, peritoneal dialysis, or kidney transplantation, please contact our Kidney Disease Care Center. Our professional medical staff will provide detailed explanations. Do not believe exaggerated or inaccurate rumors that may delay proper treatment.
(The image below is adapted from the Chronic Kidney Disease Management Handbook.)

Stages of Chronic Kidney Disease