Dialysis Options: What You Need to Know Before Choosing a Treatment

When your kidneys can’t do their job anymore, dialysis, a medical treatment that filters waste and excess fluid from the blood when kidneys fail. Also known as renal replacement therapy, it’s not a cure—but it keeps you alive. About 800,000 people in the U.S. rely on dialysis each year, and most don’t realize there are two main types: hemodialysis, a process where a machine filters your blood outside your body, usually done at a clinic three times a week and peritoneal dialysis, a method that uses the lining of your abdomen to filter blood, often done at home daily. The choice isn’t just about medical need—it’s about your lifestyle, your schedule, and your comfort.

Most people start with hemodialysis because it’s what clinics offer first. But it’s not the only path. With peritoneal dialysis, you can do treatments while you sleep, travel with a portable system, or avoid frequent trips to a center. But it comes with its own risks: infections around the catheter site, or fluid imbalances if you don’t follow the rules. Neither option is easy. Both require strict diet control, fluid limits, and daily attention to your body’s signals. Some people switch between them. Others start with one and move to the other after complications. What matters isn’t which is "better"—it’s which fits your life right now.

And it’s not just about the machines or the tubes. Your success depends on how well you understand your own body. If you’re on hemodialysis, you need to know how your weight gain between sessions affects your blood pressure. If you’re doing peritoneal dialysis, you need to spot early signs of peritonitis before it turns dangerous. That’s why so many of the posts below focus on tracking symptoms, communicating with your care team, and avoiding common mistakes—like skipping doses, ignoring swelling, or delaying treatment because you’re tired. This isn’t theoretical. These are the daily decisions that keep people alive.

Below, you’ll find real, practical guides from people who’ve been there: how to manage side effects, what to ask your nephrologist, how to spot warning signs, and how to handle emergencies. No fluff. No marketing. Just what works when your kidneys aren’t working.