Peritoneal Dialysis FAQs

Yes, PD requires a procedure to insert a soft catheter into the abdomen, but it’s typically a minor surgery. The placement usually takes about 15-30 minutes and is often done under local anesthesia or mild sedation (sometimes called “twilight” anesthesia)—homedialysis.org

PD treatments are not painful, though some patients feel bloated during the acclimation period. One big relief for many is that PD involves no needles during daily treatment—the dialysis fluid is infused through your abdominal catheter, so you avoid the pokes that hemodialysis requires—freseniuskidneycare.com

Travel is very much possible on PD, and in many ways it’s easier than traveling on hemodialysis. Dialysis providers will coordinate to have your PD supplies delivered to your travel destination ahead of time (even internationally, in many cases).

Good news: Most PD patients adjust well and continue to sleep soundly. If you choose automated peritoneal dialysis (APD), it is done overnight while you sleep—the machine (cycler) will fill and drain your abdomen several times during the night. It’s natural to wonder if that will keep you awake, but it shouldn’t.

PD generally comes with a more liberal diet compared to standard in-center hemodialysis. Because PD is happening every day, your body isn’t experiencing big swings in waste buildup between treatments. This means you usually don’t have to restrict potassium, sodium and fluids as severely as someone on three-times-a-week HD. For example, many PD patients can enjoy fruits and vegetables that HD patients might need to limit (like bananas, tomatoes and potatoes which contain potassium)—my.clevelandclinic.org

Yes! One of the main perks of PD is that it offers far more flexibility to maintain work, school and daily activities compared to in-center dialysis. Many PD patients keep full-time jobs, can attend school or care for family while successfully doing dialysis.

Studies have found that the overall infection rates on PD are comparable to those on hemodialysis when you consider all types of infections. PD patients do face peritonitis risk, but they avoid life-threatening bloodstream infections that are more common with hemodialysis needles or catheters—davita.com

Patients can absolutely do PD at home, even with no medical background. PD is designed as a patient-friendly, self-care therapy, and extensive training is provided to make sure patients feel comfortable and confident. Most people train over about 5 days or less of sessions, although training is always tailored to their pace. —th.mykidneyjourney.com

One of the advantages of PD is that it allows independence, which can actually reduce the burden on family compared to in-center dialysis. Many PD patients do not require a caregiver’s day-to-day help once they are trained. The patient won’t need someone to drive them to a clinic three times a week (which is a common need for in-center hemodialysis). Instead, the patient is welcome to spend their time at home with their loved ones while receiving treatment.

Peritoneal dialysis can be a viable therapy for many years, and some people have been on PD (or a combination of PD and other dialysis) for decades. There isn’t a strict time limit for how long PD lasts—it varies by individual. On average, patients may remain on PD for five years or more before a change in treatment might be needed. With the advances in infection prevention highlighted earlier, we can expect that average to extend (patients that avoid infection have persisted with PD for more than 20 years).

Both PD and hemodialysis (HD) are proven, life-sustaining treatments for kidney failure—PD is equally effective when performed as prescribed. In terms of clearing toxins and removing fluid, PD and HD achieve similar outcomes, just on different schedules. Multiple studies and reviews have found no significant difference in overall survival between PD and in-center HD—pubmed.ncbi.nlm.nih.gov

In fact, current data is showing marked health benefits for patients heart and kidney health. Because PD is a gentler and more regular treatment, it slows the decline of residual kidney function (RKF) compared to hemodialysis, supporting improved fluid balance, blood pressure control and toxin clearance—all linked to higher survival and better overall health.

Hemodialysis is most preferable for those who cannot manage self-care or who have certain medical conditions that make PD unsuitable (for example, extensive abdominal surgeries my.clevelandclinic.org). Since HD is usually done in a clinic (unless you train for home HD), you will have nurses doing the treatment, but you also have to adhere to their schedule and travel there.

PD is not more expensive for patients. In fact, it’s often less expensive than HD. From an insurer’s perspective, PD is definitely cost-effective. For example, recent Medicare data show that the average annual cost to Medicare for a PD patient is about $87,000 per year, whereas for an in-center HD patient it’s about $99,000 per year while provider reimbursement actually remains the same—goodrx.com

Current health policies have encouraged home dialysis (PD or home HD) mostly because of its cost savings beyond the obvious quality-of-life benefits. There are even initiatives and incentives by Medicare that both providers and patients can take advantage of to increase the use of home dialysis, and care delivery models are evolving to support it.