| Hemodialysis | Peritoneal Dialysis | |
|---|---|---|
| Process | Rapid—uses either external AV shunt (acute renal failure) or internal AV fistula (chronic renal failure); typical treatment is 3–4 hr, 3 days/wk; also used for barbiturate overdoses to remove toxic agent quickly | Intermittent—up to 36 hr for hospitalized clients; outpatient 4–8 hr, 5–6 times per week; dwell time 30–45 min for manual dialysis or 10–20 min for automatic cycler; either rigid stylet catheter or surgically inserted soft catheter; advantage for clients who cannot tolerate rapid fluid and electrolyte changes Continuous—two methods: (1) four cycles in 24 hr; dwell time is 4–5 hr during the day and 8–12 hr overnight; no need for machinery, electricity, or water source; surgically inserted soft catheter; closely resembles normal renal function; (2) automated cycler infuses and removes dialysate; generally done while client sleeps; built-in alarms for client safety. |
| Vascular access | Required | Not necessary; therefore suitable for clients with vascular problems |
 Heparinization | Required: systemic or regional | Little or no heparin necessary; therefore suitable for clients with bleeding problems |
| Complications (other than fluid and electrolyte imbalances, which are common to all) | Dialysis dysequilibrium syndrome (preventable) Mechanical dysfunctions of dialyzer | Peritonitis Hypoalbuminemia Bowel or bladder perforation Plugged or dislodged catheter |