Advantages

1. Higher solute clearance allows intermittent treatment

2. Parameters of adequacy of dialysis are better defined and therefore under-dialysis can be detected early

3. The technique's failure rate is low

4. Even though intermittent heparinization is required, hemostasis parameters are better corrected with hemodialysis than peritoneal dialysis

5. In-center hemodialysis enables closer monitoring of the patient Disadvantages

1. Requires multiple visits each week to the hemodialysis center, which translates into loss of control by the patient

2. Dysequilibrium, dialysis, hypotension, and muscle cramps are common. May require months before patient adjusts to hemodialysis

3. Infections in hemodialysis patients may be related to the choice of membranes, the complement-activating membranes being more deleterious

4. Vascular access is frequently associated with infection and thrombosis

5. Decline of residual renal function is more rapid compared to peritoneal dialysis

From Foote EF, Manley HJ. Hemodialysis and peritoneal dialysis. In: DiPiro JT, Talbert RL, Yee GC, et al., (eds.) Pharmacotherapy: A Pathophysiologic Approach. 7th ed. New York: McGraw-Hill; 2008: 0104, with permission.

Table 26-9 Advantages and Disadvantages of Peritoneal Dialysis

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