Dialysis: Price, Principles, Procedures and Side Effects

According to the International Society of Nephrology, kidney disease is one of the fastest-growing chronic diseases in the world. Once your renal function falls to less than 15%, you must receive dialysis. Does dialysis have side effects? What are the differences between peritoneal dialysis and hemodialysis? Cigna Smart Health analyses the principles, procedures, pros, and cons of dialysis for you!

Why Do You Need Dialysis?

The major function of kidneys is to eliminate metabolic waste and water waste in the body. If your renal function deteriorates or is damaged, the waste accumulates in the blood, leading to hematuria (urine with blood) and proteinuria. Once your renal function falls below 25%, you are considered to have kidney failure. If your renal function is at or below 15%, your kidneys will fail to operate, and you require dialysis or even a kidney transplant to maintain your life.

Peritoneal Dialysis & Hemodialysis

Nowadays, there are two types of dialysis, namely peritoneal dialysis and hemodialysis. The former can be conducted at home, but you need to receive the latter at a medical organization. The below table summarises the principles, procedures, pros and cons, and preparation for your easy comparison between the two ways of dialysis. Before making your decision, you should consult your doctor and consider your personal needs.

Types of Dialysis	Peritoneal Dialysis	Hemodialysis
Principles	Use the inside lining of your abdomen (the peritoneum) as the filter for purifying the blood	Remove blood from your body, filter it through a dialyzer (artificial kidney) and return the cleaned blood to your body.
Procedures	1. Dialysis fluid is pumped into the peritoneal cavity through the catheter. 2. As blood passes through the blood vessels lining the peritoneal cavity, waste products and excess fluid are drawn out of the blood and into the dialysis fluid after 6-8 hours. New fluid is required upon finishing the procedures.	1. A tube is attached to a needle at your neck, below your collarbone or the veins of your groin for passing the blood to the dialyzer. 2. Through the dialyzer, or called the artificial kidney, toxins and water in the blood are filtered and purified before passing back to your body
Advantages	Keep the remaining renal function Flexible time of receiving the treatment No injection is needed Less pressure on the cardiovascular system Less risk of blood infection Less limitation on the diet	No need to handle it by yourself Only require around 12 hours per week
Disadvantages	Result in peritonitis without proper operation Speed up the loss of protein Unintentional weight gain Elevated blood triglycerides Need to operate by yourself	Frequent visit to the hospitals for the procedures Require a permanent catheter (tube) Bleeding at the site of connection Poor cardiovascular function High change of low blood pressure
Time Required	Changing the fluid usually takes about 20 to 30 minutes and normally needs to be repeated 3-5 times a day.	Three times a week, 4 hours per course of hemodialysis
Preparations	1. You need to have a minor surgical procedure to insert a soft, thin tube (catheter) through your belly and into the peritoneum. This catheter stays in place permanently. 2. Before the wound heals, you are required to receive intermittent peritoneal dialysis or hemodialysis for removing toxins and waste. 3. After healing, you need to learn how to operate the procedures and related care.	1. You need to undergo a minor surgical procedure to make it easier to access the bloodstream by building vascular passages (including arteriovenous fistula and arteriovenous graft) 2. You should clearly understand the procedures and learn the after-care for preventing complications

Fees of Dialysis

According to the Hospital Authority, the fees of peritoneal dialysis and hemodialysis have a flat rate of HK$96. However, the need for dialysis increase over time. You may not be able to receive the treatment at your district hospital.

In the private sector, dialysis fees are relatively costly, from HK$1,950, depending on your package and hospitalization charges. You may also need to pay extra for the consultation fees, medicines, and laboratory fees.

Fees of Hemodialysis

You can take a look at the following charges of hemodialysis provided by five local private hospitals for your reference.

Medical Organisations	Fees of Dialysis* (Hemodialysis)
Hong Kong Sanatorium & Hospital	From HK$2,890 per session
Canossa Hospital (Caritas)	From HK$4,180 per session
Hong Kong Baptist Hospital	From HK$2,130 per session
Gleneagles Hospital	From HK$1,950 per session
Hong Kong Adventist Hospital – Stubbs Road	From HK$3,080 per session

*Charges taken from the respective medical organization as of 15 Dec 2021

Fees of Peritoneal Dialysis

If you would like to undergo peritoneal dialysis at home, you need to buy the dialysis fluid, disinfectants, and automatic dialytic machine. For the device, you can also rent from a dialysis center. The monthly rental fees of the dialyzer are from HK$3,000 to HK$5,000, while the cost of a brand-new machine is up to HK$80,000.

Side Effects of Peritoneal Dialysis & Hemodialysis

Although dialysis can remove the waste in your blood, you may experience some side effects, such as nausea and vomiting, during the procedures. Below are the possible side effects and complications of the two methods.

	Peritoneal Dialysis	Hemodialysis
Side Effects	Sleeping problems High blood sugar Pelvic pain Muscle cramping Acid reflux Electrolyte and water imbalance	Fluctuated blood pressure Nausea Vomiting Headache
Complications	Peritonitis Inflammation of the catheter Inflammation of the subcutaneous duct Obstructed or displaced catheter Abdominal hernia	Angina pectoris Myocardial infarction Muscle spasms Imbalance Syndrome

Besides, an insufficient intake of protein may lead to a breakdown of the protein in your muscles, resulting in weight loss, weak immunity, wound healing ability etc.

Although dialysis is a lengthy and repetitive procedure, not all people with kidney disease require lifetime dialysis. This is because the primary purpose of dialysis is to help patients filter and purify the blood to improve the symptoms of uremia. With proper treatment, lifestyle changes and a balanced diet, patients can restore their renal function gradually.

Worsening renal function is hardly noticeable. Regular check-ups are good for early diagnosis and can mitigate the chance of further deterioration. Cigna VHIS Series Flexi Plan (Superior) not only covers numerous medical services, including full compensation for hospitalization, surgery, diagnostic imaging tests, but also enables an enhanced benefit of outpatient kidney dialysis. Cigna gets your medical needs covered! Click here to understand more about Cigna VHIS Series.