Which is better, PD or HD?

Experts Check: Which is better, PD or HD?

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Note: This article is only to guide and increase your knowledge. Before taking any action, you can consult “drhealthandbeauty” doctors or your doctor for treatment.

Kidney acts as a purification of toxic substances and body waste. Therefore, it is one of the most important organs of the body. Now think that there will be a disruption in the performance of this vital organ! Even the thought of toxic substances accumulating in the body is very alarming. And you have to think of a solution.

Over the years, medical scientists have invented a method in which the overall function is simulated by a device. Yes, dialysis is the name of this method. Using this method, the patient’s blood is purified and waste materials do not remain in his body.

Maybe you also ask yourself that “Can Kidneys Start Working Again After Dialysis?“. This question is discussed in detail in the relevant article.

Today, there are various types of kidney dialysis. In this article from Drhealthandbeauty by Dr. Sanaz, we have introduced various dialysis methods, such as hemodialysis ( HD ) and peritoneal dialysis ( PD ). We have also examined the difference between hemodialysis and peritoneal dialysis, and finally will answer the question, which method is better?

Table of Contents
Which is better, PD or HD? 012

What is meant by kidney dialysis?

Kidney is one of the internal organs of the body of living beings, especially humans, whose main task is to purify the blood from waste and contaminated substances.

By purifying the blood, the kidney transports waste materials through the blood to the bladder, where they are removed from the body with the help of urine. If the kidney cannot do its job properly, the waste material remains in the human body, which is very dangerous and sometimes fatal. In such cases, it is said that people have kidney failure. And the person’s health is at risk. So it is important to know What Are The Signs That You Need Dialysis? 

Kidney dialysis is a treatment for patients with kidney failure. The effectiveness of dialysis is due to the fact that with dialysis, the blood of the kidneys is emptied of waste materials with the help of special purification devices.

If the kidney does its job properly and cleans the blood of waste products, people’s blood pressure remains under control. Also, vitamin D is produced in the body, which allows better absorption of calcium, which otherwise kidney dialysis would do. It will do the process.

Dialysis methods

Dialysis is a treatment method that is sometimes considered necessary and vital for some kidney patients. So it is important to know What Happens If you Skip Dialysis?. Peritoneal dialysis ( PD ) and hemodialysis ( HD ) are types of dialysis treatments used for people who need blood purification due to kidney disorders. Both methods remove waste and harmful substances from the blood added to the body. Still, each performs this task with different mechanisms. We will examine each one below.

1- Hemodialysis ( HD )

Blood dialysis is one of the most common and common methods to dialyze patients with kidney failure. This method works in such a way that an artificial kidney (dialyzer) removes excess and waste materials from the body and the removed blood is purified with the help of the artificial kidney.

After the contaminated blood removed from the body is purified with the help of the artificial kidney, the dialysis machine returns the purified blood to the body. For the blood to flow in the artificial kidney, there must be a way to connect to the dialysis machine, which the specialist doctor creates in the patient’s body with the help of surgery to connect the vascular path to the dialysis machine.

You should know that this method is usually performed regularly in specialized centers. It requires a hemodialysis machine and a medical and nursing team. This method should usually be done for several hours a week.

  • Advantages of hemodialysis:

    • You can connect with other dialysis patients, which may strengthen your social network and heart.
    • This procedure is performed by the most specialized health professionals, who can manage any problem.
    • Compared to peritoneal dialysis, hemodialysis is performed fewer times per week and for a shorter period.
    • Unlike peritoneal dialysis ( PD ), you don’t need to do this procedure yourself; you use the most specialized nurses.
    • Home hemodialysis gives you more freedom to choose each dialysis session’s time, place, and duration.
  • Disadvantages of hemodialysis:

    • You may feel tired during the day.
    • It increases the risk of blood infections.
    • This method can cause problems such as low blood pressure and blood clotting during dialysis.
    • Some changes to your home may be needed, and you and a trusted friend will need to complete the training steps.
Hemodialysis 4125865

2- Peritoneal Dialysis ( PD )

Another method to dialyze the kidneys is the peritoneal dialysis method. There is a natural membrane called the peritoneum in the stomach of people, which is used in the peritoneal dialysis method. There are holes in this curtain that act like a filter and excess body waste can be removed.

In the peritoneal dialysis method ( PD ), a catheter is placed inside the patient’s abdomen through surgery. This catheter purifies blood using the peritoneum in the abdomen.

This method works by letting dialysis fluid enter the peritoneum and absorbing the existing waste materials. After the process is completed, the fluid must be drained from the abdomen. Normally, this procedure takes a few hours and should be done four or six times a day.

It should be noted that peritoneal dialysis ( PD ) has various types, including continuous inpatient and continuous outpatient peritoneal dialysis, intermittent peritoneal dialysis, and continuous circulating peritoneal dialysis.

  • Advantages of peritoneal dialysis:

    • This method gives you more freedom. You can do it alone and alone at home or anywhere, even while traveling or sleeping.
    • In peritoneal dialysis, there is no need to use a needle.
    • Unlike hemodialysis, there are no food and fluid restrictions in this method.
  • Disadvantages of peritoneal dialysis:

    • For some people, this may be difficult to do.
    • Peritoneal dialysis increases the risk of infection of the abdominal membrane (peritonitis).
Peritoneal Dialysis 58646

Which patient, which dialysis method?

Peritoneal Dialysis and Hemodialysis each have their characteristics advantages and disadvantages, and the medical team should determine the choice between these two methods based on each patient’s condition and individual needs. Below are some cases for which each method can be suitable:

Hemodialysis ( HD )

  • This treatment is suitable for people who:

    • A person who needs dialysis for urgent reasons: Hemodialysis is suitable in cases where the kidneys are not fully functioning and the patient needs urgent blood purification.
    • Lack of access to peritoneal dialysis ( PD ) equipment and facilities: Some patients cannot use peritoneal dialysis due to their environmental and local conditions and may not have access to it for financial reasons.
    • A general condition requiring blood purification: People in good general condition who need dialysis for other reasons may choose hemodialysis.
  • This treatment is not suitable for people who:

    • Unfavorable cardiovascular condition: People with serious cardiovascular problems who cannot transfer enough blood to the hemodialysis machine may not be suitable for hemodialysis.
    • Lack of access to dialysis centers: For people who do not have access to dialysis centers, hemodialysis may be impossible.
    • Inappropriate physical tolerance: hemodialysis requires high physical tolerance. People who are physically disabled or cannot tolerate hemodialysis sessions for other reasons are not suitable.
    • Side effects from hemodialysis: Some people may be sensitive to the side effects of hemodialysis, such as low blood pressure, blood clots, or blood infections.

Peritoneal Dialysis

  • This treatment is suitable for people who:

    • A person who prefers to do dialysis at home: If a person prefers to do dialysis at home and at times convenient for him, then peritoneal dialysis ( PD ) is a suitable option.
    • Complications and problems related to hemodialysis: Some people may be allergic to the complications of hemodialysis or have cardiovascular problems, in which case hemodialysis is unsuitable.
    • Physical tolerance: People with high physical ability who do not have any problems with peritoneal dialysis may choose this method.
    • However, the medical team should make the final decision on the type of dialysis based on the individual’s condition and needs. Also, in some cases, people may need to change from one method to another based on changes in their kidney condition over time.
  • This treatment is not suitable for people who:

    • Peritoneal membrane infection: Peritoneal dialysis is unsuitable for people with infections or problems with the abdominal membrane.
    • History of abdominal surgery: If a person has a history of surgery in the abdominal area, this may cause problems in performing peritoneal dialysis.
    • The medical team should decide on the appropriate type of dialysis based on the individual’s physical condition, medical history, and needs. In some cases, people may need to switch from one method to another due to changes in their personality status.
Which is better, PD or HD? 019

PD or HD, which one is more suitable for the patient?

Determining whether Peritoneal Dialysis or Hemorrhodialysis is more suitable for a patient depends on several factors, including the patient’s health status, medical history, and physician’s recommendation. Both dialysis methods have advantages and disadvantages, and the choice of the best method should be made based on each patient’s specific needs and circumstances.

General health condition: The general condition of the patient is very important. Some patients may be unsuitable for hemodialysis due to other problems such as heart, respiratory, or general condition, in which case peritoneal dialysis is better.

Kidney level and kidney function: Kidney function affects the choice of dialysis method. Hemodialysis may be the best option in cases where the patient’s kidney function is so weak that dialysis is needed to remove waste products from the blood.

Physical condition of the patient: Physical condition can also be effective. Some patients cannot easily go to hemodialysis centers due to physical problems. In these cases, peritoneal dialysis may be more appropriate.

Patient preferences: Patient preferences and opinions can also influence the choice of dialysis method. Some people may prefer to have dialysis at home (peritoneal dialysis). In contrast, others may prefer to go to a dialysis center (hemodialysis).

Related: “What Is The Maximum Life After Kidney Dialysis?

Which is better, PD or HD? 020

Which dialysis method requires a machine?

Hemodialysis requires a special device known as a Dialyzer. The dialyzer is the main device in the hemodialysis process. It purifies the blood from waste and toxic substances.

The dialyzer consists of two main parts:

Membrane: A membrane is a single piece of semi-permeable material used to separate waste materials from the blood. It is usually made of polysulfone or synthetic polyester. The patient’s blood enters the dialyzer from a syringe and passes through the membrane.

Dialysate fluid: This fluid contains special compounds of chemicals that purify the blood. The dialysis fluid is pumped into the dialyzer and after the purification process, it is returned to the dialysis machine.

Dialyzers are controlled by nurses or specialized technicians in dialysis centers. This device performs the hemodialysis process. Normally, hemodialysis sessions should last a few hours each time, and this process continues to purify the blood from waste and toxic substances


Knowing this may change your choice.

In Peritoneal Dialysis, you do not need a needle to enter the blood. This is one of the important differences between peritoneal dialysis and hemodialysis.

In peritoneal dialysis, purification is done through the semi-artificial membranes of the stomach (peritoneal membrane). The dialysis fluid is injected into the person’s abdomen and has access to the blood through these membranes. In other words, you don’t need to enter the blood vessels directly, and the procedure can be performed at home or in settings where access to hemodialysis equipment is limited.

In hemodialysis, to access the patient’s blood, needles are inserted into the blood vessels (usually in the hand and sometimes in the forearm) so that the blood enters the hemodialysis machine and is returned to the patient after purification. These needles are connected to the hemodialysis machine, and the purification process is done inside the dialyzer.

Frequently asked questions

How are dialysis substances purified from blood in peritoneal dialysis?

In peritoneal dialysis, blood is filtered through the semi-artificial membrane of the stomach (peritoneal membrane). The purification steps are as follows:

  • Injection of dialysis fluid: First, dialysis fluid is injected into the person’s abdomen. This liquid contains special chemical compounds that absorb waste materials from the blood.

Performing dialysis: the dialysis fluid stays inside the abdomen and is in contact with the blood. Waste and toxic substances are transferred from the blood through the membrane to the dialysis fluid.

Removal of dialysis fluid: After some time, the dialysis fluid and waste material are removed from the stomach. This process is known as “withdrawal” or “low-water dialysis.”

  • Injection of new dialysis fluid: After the dialysis fluid that contains waste materials is removed, some new dialysis fluid is injected into the abdomen to continue the dialysis process.

This process is performed continuously during hemodialysis ( HD ) sessions, and the number and duration of each session are determined depending on the patient’s condition. In both methods, waste materials are transferred from the blood to the dialysis fluid, and then the dialysis fluid with the waste materials is removed from the body.


How are dialysis substances purified from blood in hemodialysis?

In hemodialysis ( HD ), blood is purified through a dialyzer and a hemodialysis machine. The purification steps are as follows:

  • Injecting blood into the dialyzer: The patient’s blood is injected into the dialyzer from a syringe. The dialyzer consists of a membrane that transfers waste materials from the blood to the dialysis fluid.
  • Blood purification in the dialyzer: the blood in the dialyzer is mixed with the dialysis fluid and waste materials are transferred from the blood to the dialysis fluid.
  • Returning purified blood to the patient: After purification, the purified blood is returned to the patient.


Does dialysis have complications?

Although the process of dialysis improves the condition of kidney patients and saves them from death, this method has complications such as low blood pressure, anemia, insomnia, depression, irregular heartbeat, malnutrition, fever, abdominal pain, and infection. It has blood problems, increased blood potassium levels, muscle spasms, weight gain, etc., which may be very painful for patients, especially elderly patients.


Finally, choosing between dialysis methods, including hemodialysis ( HD ) and peritoneal dialysis ( PD ), is a critical decision for patients with kidney problems. Both methods have advantages and disadvantages, and their effectiveness depends on each patient’s physical and medical condition. To choose the best dialysis method, working closely with the attending physician and treatment team is very important. This choice can help patients have the best quality of life and health possible in the face of their kidney problems.

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Author and specialist

Dr. Majid Zahrabi,


  • Board Certified Neurosurgeon
  • DHA certificate holder
  • Plantation certificate holder, France
  • Certified holder of Discogol, France
  • A pioneer in the non-surgical treatment of disc herniation in the Middle East and CIS countries.
  • Under the training and coaching of Professor Jacques Theron (founder of Discogel Therapy) since 2008
  • More than 400 successful cervical and 1300 lumbar discogel injections
  • Trained and certified several neurosurgeons and spine surgeons in the Middle East and CIS countries for the treatment of Discogel
  • Strong belief in patient-centered care planning and participation
  • Neurosurgeon and spine surgeon at Imam Khomeini and Amir Mazandarani Hospital, Sari, Iran, with more than 430 surgeries annually, 2000-2011
  • Neurosurgeon and spine surgeon at Farmaniyeh, Nikan and Yas Sepid Hospital, Tehran, Iran, with more than 400 surgeries annually, 2011-2012
  • Neurosurgeon at Iranian Hospital, Dubai, 2022-2023
  • Since 2015, he has been working as a reference doctor for the treatment of intervertebral disc herniation with Discogel and has trained many doctors of spine-related specialties in various countries of the Middle East and CIS in person/practically and online.



  • Individual training sessions under the direct supervision of Professor Jacques Theron in Discogel treatment, 2008-2020
  • Training sessions under the supervision of Professor Thierry Boye on spinal implants, 2007
  • Participation and presentation in several national and international medical and neuro-spinal conferences
  • Board certificate by Iran Neurosurgery Board, 2001
  • Neurosurgery assistant training course, Isfahan University of Medical Sciences, Isfahan, Iran, 1996-2001 (In 2001, he graduated from Isfahan University of Medical Sciences with the first rank in the country.
  • His thesis the titled:The Application of human amniotic membrane in repair of dura matter in dogs.” ( It was happening for the first time in the world. )
  • General medical education, Tabriz University of Medical Sciences, Tabriz, Iran, 1984-1993


Published books:

  • CT scan of the brain for doctors
  • Etiology and treatment of painful spine disorders
  • Atlas of diagnosis, prevention, and treatment of spine disorders
  • The most common mistakes in the treatment of spinal disorders
  • Reading brain CT scan in simple language (3rd place in the book of the year)
  • Treatment of head and spine injuries

Publications and articles:

  • Bacteriostatic and bactericidal effects of DISCOGEL® (https://www.researchgate.net/)
  • Muscle recovery, reduction of pain, and improvement of movement strategies in patients with lumbar discopathy after injection of Discogel.
  • The article on the initial results of the treatment of intervertebral disc herniation with discogel injection, which won the second-best poster rank at the Pan Arab International Congress of Interventional Radiology (March 14-16, 2015) and was accepted for presentation at the Chicago Pain Congress.
  • The use of human amniotic membrane in dura mater repair in dogs, a study for the first time in the world.



  • Annual Congress of Physiotherapists of Iran, 2019
  • Chicago International Pain Congress, 2019
  • Iran International Pain Management Congress, 2018
  • Annual Congress of Physiotherapists of Iran, 2018
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Armenia for orthopedic specialists and neurosurgeons, 2017
  • First Live Workshop and Seminar on Minimally Invasive Disc Therapy (DISCON), 2017
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Azerbaijan for orthopedic specialists and neurosurgeons, 2016
  • Seminar of Iranian official managers, 2016
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Tajikistan for orthopedic specialists and neurosurgeons, 2016
  • International Neurological Intervention Congress in Iran, 2014
  • Educational seminar for nurses on treatment approaches for head and spine trauma, 2014
  • Educational seminar for general practitioners on treatment approaches for head and spine trauma, 2014
  • Speech at the Retraining Seminar for General Practitioners and Specialists in Dubai (Discon) in 2017
  • Speech in the internal retraining courses of Irani Hospital, Dubai
  • Holding lecture sessions and practical workshops on the treatment of intervertebral disc herniation with discogel injection in Azerbaijan, Tajikistan, Ukraine, Oman, and Armenia during the years 2015 to 2021.
  • Giving a lecture and holding a practical workshop for neurosurgeons in Vietnam at Ho Chi Minh City University in 2023

Dr. Majid Zohrabi started treating his patients in Dubai in 2022 and continues his activities in private medical centers in the UAE.