Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis

Patients with end-stage renal disease or a drug overdose may require extracorporeal removal of drugs and their metabolites.

The most common technique, dialysis, removes waste products and drugs via diffusion and filtration into the dialysis fluid with the dialyzer acting as an artificial kidney. Two common types include peritoneal dialysis and hemodialysis.

In peritoneal dialysis, the peritoneal membrane acts as a filter.

A catheter is placed in the abdominal wall, and dialysis fluid is pumped into the peritoneal cavity, which helps remove waste from the body’s fluid. Periodically, the dialysate is drained and replaced with fresh dialysate.

In contrast, during hemodialysis, blood passes through the dialysis machine, where an artificial membrane removes waste materials before reintroducing the blood into the body.

The dialysis frequency varies from once every two days to three times a week, with each treatment time varying in duration.

It is influenced by factors such as residual renal function and patient characteristics.

Peritoneal dialysis is performed at home, enabling self-treatment, whereas hemodialysis, typically performed in a dialysis center, is preferred in emergencies.