Dialysis or Transplant?

Chronic kidney disease is a condition in which a kidney gradually loses its ability to properly function, and when the kidney reaches end-stage renal disease (ESRD), this is described as kidney failure. At this point, the kidney loses its ability to adequately eliminate fluid and waste, thereby poisoning the body.

Healthy kidneys effectively remove waste products from the blood and produce important hormones that help build strong bones, stimulate the growth of red blood cells and regulate blood pressure. When kidneys fail, toxic waste products build up in the blood. This accumulation of urine and other nitrogenous wastes, along with decreased red blood cell production and increased blood pressure, can lead to significant health problems and can be fatal if left untreated. Kidney failure can be treated either through dialysis – using a machine or special fluid to clean your blood – or a transplant.

With hemodialysis, a machine acts as an artificial kidney, passing your blood over a filter to remove fluid and waste products and then returning the blood to your body. This is typically done under the supervision of a clinician at a dialysis center. Patients usually come in for treatment three times per week, and each session lasts about three-four hours.

For peritoneal dialysis, a small tube is inserted in the patient’s abdomen. A special fluid is pumped into the abdomen, where it absorbs wastes and extra fluid from your body and then is drained out of the body. This can be done either manually, four or fives per day, or automatically by a machine while you’re sleeping. Patients sometimes prefer this type of dialysis because it can be performed by the patient at home or at work.

Many patients, however, prefer a kidney transplant. Unlike long-term dialysis, a renal transplant provides a life expectancy comparable to that of individuals without kidney disease, and it also provides an improved quality of life.

Learn more about Brigham and Women's Hospital


For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery.

About BWH