Frequently Asked Questions by Dialysis Patients

Which is a better dialysis modality – haemodialysis or peritoneal dialysis?

Both haemodialysis and peritoneal dialysis serve the same purpose to remove unwanted toxins and excess fluid from patients with kidney failure. There are some observational studies that suggest peritoneal dialysis may have some advantages over haemodialysis in the first one to two years of initiation due to the better preservation of residual kidney function in peritoneal dialysis. However, after the initial first two years, the mortality benefit is similar.

The dialysis modality of a patient should always be based on a discussion and joint decision between the patient and a nephrologist to ascertain the most suitable modality for long term therapy. The patient’s concurrent medical conditions, living situation, caregiver support, mobility, and ability to commit for home-based therapy will all play a part in the decision-making process.

Can I travel even if I am on dialysis?

Yes. Travel is certainly possible although it will take some pre-travel arrangements in the destination country to ensure that haemodialysis facilities are available upon arrival. For patients on peritoneal dialysis, arrangements will have to be made prior to travelling to ensure that the appropriate equipment and dialysate bags will be made available for the patient to continue their treatment at their destination.

Can I skip a dialysis session?

Ideally, patients should keep to their scheduled treatments to maintain better continuous clearance of toxins and excess fluid. A haemodialysis patient should dialyse three times a week and a peritoneal dialysis patient should be doing their treatments daily as far as possible. If any deviation from this is necessary, it would be advisable for the patient to discuss this with their managing nephrologist.

Can I eat what I want once I have started on dialysis?

Although dialysis is an effective treatment for removing excess toxins and fluid, dialysis patients will still need to adhere to a renal specific diet. However, there are some exceptions. For example, a peritoneal dialysis patient can be allowed a more liberal intake of potassium in their diet because potassium levels tend to be lower in patients undergoing peritoneal dialysis. That said, any diet modifications should be made in consultation with a dietitian or nephrologist.

What are the fluid restrictions while on dialysis?

Generally, a dialysis patient would be advised to restrict their fluid intake to less than 1L a day. This would include fluids from drinks (e.g water and juice) and food (e.g soup and fruits). The amount of excess fluid that can be removed from the dialysis process is limited. Patients will have to do their part to reduce fluid consumption to avoid fluid overload.

Can I exercise as a dialysis patient?

Yes, exercise is encouraged to improve mobility and general well-being. The purpose of dialysis is not only to add years to life but also to improve the quality of living. Appropriate exercise will do wonders to a patient’s well-being.

The only exception, in terms of the types of exercise allowed, is that patients with either dialysis catheters or peritoneal dialysis catheters will not be able to swim or participate in any sport that requires water immersion.

Is there really a higher risk of infection when doing peritoneal dialysis?

The risk of peritonitis (infection of the peritoneal space) in a peritoneal dialysis patient is no higher than catheter related dialysis infections in patients undergoing haemodialysis via a dialysis catheter. Peritoneal dialysis peritonitis is infrequent and mostly easy to treat. The key to reducing the risk of peritoneal dialysis related infections is adherence to the peritoneal dialysis exchange techniques and good general hygiene.