The two main types of dialysis are haemodialysis and peritoneal dialysis. Haemodialysis removes blood from the body and passes it through a machine that filters waste and excess fluid before returning the blood. Peritoneal dialysis uses the lining of the abdomen as a natural filter. Dialysis fluid is placed into the abdomen through a catheter and later drained, carrying waste and excess fluid with it. The choice depends on kidney function, overall health, lifestyle, home situation and personal preferences.

During haemodialysis, blood is taken from the body through a vascular access and passed through a dialyzer, which acts as an artificial kidney. The filter removes waste products, excess salts and fluid from the blood, which is then returned to the body. Haemodialysis may be performed at a dialysis centre, hospital or, for selected patients, at home. Treatment requires a regular schedule, along with prescribed medicines, dietary adjustments and monitoring of blood pressure, weight, blood chemistry and dialysis effectiveness.

Peritoneal dialysis uses the peritoneum, the natural lining of the abdomen, as a filter. A catheter is placed into the abdomen, through which dialysis solution enters the abdominal cavity. The solution remains there for a period of time, allowing waste and excess fluid to move from the blood into the solution. The used fluid is then drained and replaced with fresh solution. Peritoneal dialysis is generally performed at home and can offer greater flexibility for some patients, including those who work or travel.

The choice between haemodialysis and peritoneal dialysis is individualised. Doctors consider remaining kidney function, overall health, other medical conditions, home environment, ability to manage treatment, lifestyle and personal preferences. Peritoneal dialysis may offer greater flexibility because it can be performed at home, while haemodialysis may be provided at a dialysis centre or at home for selected patients. The healthcare team discusses the advantages, limitations and practical requirements of each option before recommending the approach that best fits the patient's medical and personal needs.

Symptoms of advanced kidney failure can include persistent nausea or vomiting, loss of appetite, severe tiredness or weakness, itching, swelling of the feet and ankles, changes in urination, shortness of breath, difficulty sleeping or reduced mental alertness. However, symptoms alone do not determine whether dialysis is needed. Doctors also assess kidney function, fluid levels, blood potassium, acid levels, overall health and quality of life. Anyone with worsening kidney disease symptoms should undergo medical evaluation rather than waiting for symptoms to become severe.

Dialysis requires regular treatment, prescribed medicines and dietary adjustments. Depending on kidney function and dialysis type, patients may need to manage their intake of sodium, potassium, phosphorus and fluids. A renal dietitian can create an eating plan based on individual needs. Medicines should be taken exactly as prescribed, and regular monitoring helps assess kidney function, fluid balance and dialysis effectiveness. Patients should also discuss travel, work, exercise and other daily activities with their care team so treatment can be planned around their lifestyle.