Treatment Options

Learning about your treatment and how to take an active role in your care puts you in charge. You can control things like following your treatment plan and diet and keeping a positive outlook on life. Your health care team will work with you to make a care plan that is best for you and will help you manage your treatment. You can also look to your family and friends for support. Remember that you are not alone; nearly 500,000 people of all ages live with ESRD.

Tools & Resources for New Dialysis Patients:
  • Intro. to Dialysis - Questions to Help With Your Treatment Choices: English|Spanish
  • Intro. to Dialysis - Questions to Get You Started: English|Spanish

In-Center Hemodialysis

Hemodialysis uses a machine to clean your blood. The dialysis machine has a filter called a hemodialyzer or dialyzer. The dialyzer works like an artificial kidney and removes the wastes and the extra fluid that builds up when your kidneys are not working. Hemodialysis can’t do all the work your kidneys did. Healthy kidneys work all day, every day. Hemodialysis usually occurs three times a week for about four hours each time. Your time is based on your needs. Your kidney doctor (Nephrologist) orders the length of your treatment in order to help meet your body’s needs.

To compare dialysis facilities and their treatment outcomes visit Medicare Compare.

In-Center Nocturnal Dialysis

Nocturnal hemodialysis is a slow, gentle treatment that is done at night, while you sleep; your days are left free for work or other activities. Your dialysis facility provides the machine for you. It shortens the time between treatments and the longer treatments allow less waste and fluid to build up between sessions. Nocturnal hemodialysis is easier on the heart than standard treatments and often allows a more normal diet and fewer fluid limits and medications. Most people do nocturnal hemodialysis every other day for 8 hours.

Find facilities in your area that offer in-center nocturnal dialysis at Medicare Compare.

Home Hemodialysis

Hemodialysis is typically conducted in a dedicated facility with specialized nurses and technicians who specialize in hemodialysis. However, dialysis can also be done in a patient’s home. Once you and your doctor have determined that at home hemodialysis is right for you, you will begin a comprehensive safety and training program that is tailored to your specific medical and learning needs. In most cases, you will learn to perform at home hemodialysis treatments with a dialysis partner.

There are three types of at-home hemodialysis:
  • Short Daily at-Home Hemodialysis: Performed five or six times a week, typically for two to three hours per session.
  • Traditional at-Home Hemodialysis: Performed three times per week, typically for about four hours per session. This is similar to the treatments received at a local dialysis center.
  • Nocturnal/Extended Home Hemodialysis – Performed during sleep, typically six to eight hours a night, three or more nights a week. Many patients enjoy the ability to spend the night dialyzing and not lose time during the day that could be spent at work or with family.

To locate dialysis facilities that offer home dialysis, please visit Home Dialysis Central.

To learn more about what the IPRO ESRD Network Program is doing for home dialysis, please view our Promoting Appropriate Home Dialysis webpage.

Patient Education

  • Home Hemodialysis Myths vs. Reality: Handout
  • Home Dialysis Central MATCH-D: Tool
  • Home Dialysis Central Patient Videos About Home Dialysis: Link
  • Kidney Smart Education Program: Link

Peritoneal Dialysis

Peritoneal dialysis (PD) uses the space in your belly called the peritoneal cavity to clean your blood. PD doesn’t use a dialyzer. This space is lined with a membrane called the peritoneum. It surrounds and protects your intestines, bowel, and other organs. The membrane has many tiny holes that can be used to filter waste out of your blood while keeping blood cells and proteins in your vessels.

PD usually works all day, every day. To have PD you must have an access, which is a soft, flexible tube called a catheter surgically placed in your belly. The bottom part of the tube is put into the peritoneal cavity. The middle part of the tube runs under your skin. The top part stays outside of your body and can be taped against your skin.
A liquid called dialysate travels through the catheter and fills the empty space in your belly. This liquid stays in the space while waste products and extra fluid move from your blood through the membrane into the dialysate. The dialysate with the waste products and extra fluid is then drained out of your body. Next, the space in your belly is refilled with the clean dialysate and the cleaning process begins again. The process is called an exchange. Your kidney doctor will tell you how many exchanges you should do each day and how long the dialysate should stay in your belly for it to work.

There are two types of PD:
  • Continuous Ambulatory Peritoneal Dialysis (CAPD)
  • Continuous Cycling Peritoneal Dialysis (CCPD), sometimes called Automated Peritoneal Dialysis (APD)

To compare dialysis facilities and their treatment outcomes, please visit Medicare Compare.

Patient Education

  • Home Peritoneal (PD) Myths vs. Reality: Handout
  • You Have Options! Peritoneal Dialysis: Read It!

Kidney Transplant

A transplant is when you get a kidney from another person. The person who gives you the kidney is called a donor. The donor’s blood type and tissue must match yours. The new kidney is put into your body through surgery and is usually placed in the lower part of your belly. Your old kidney may or may not be taken out during surgery. The new kidney does the work that your old kidneys did when they were working.

With a transplant, you will always need to take special medicines. Some of these medicines are called anti-rejection or immunosuppressive drugs. They help your body accept the kidney. Early signs that your body may be rejecting the new kidney can be fever, tenderness at the new kidney site, and making less urine.

To learn more about what the IPRO ESRD Network Program is doing for transplant, please view our Improving Transplant Coordination webpage.

National Transplant Information Sources

  • The United Network of Organ Sharing (UNOS): Link
  • The Organ Procurement and Transplantation Network (OPTN): Link
  • Regional Transplant Statistics: Link
  • Medicare's Coverage of Dialysis and Kidney Transplant Benefits: Brochure

Transplant Financial Resources

  • Children's Organ Transplant Association (COTA): Link
  • National Foundation for Transplants (NFT): Link