All patients were tracked through the Medicare registry. Children treated at facilities with more than 10 percent pediatric patients were 60 percent more likely to be treated with peritoneal dialysis, and those at facilities with 1-5 percent pediatric patients were 50 percent more likely to receive peritoneal dialysis, than were patients at facilities where children comprised less than one percent of patients. These differences depend on the treating facilities' experience with children. Hemodialysis uses a filter connected to a machine to clean the blood. Most patients on hemodialysis must visit their treatment center several times each week, for hours at a stretch.
Home hemodialysis requires training and space for the equipment.
Peritoneal dialysis uses the lining of the abdomen to filter blood. Fluid, wastes, and chemicals pass from tiny blood vessels in the peritoneal membrane into the dialysate. After several hours, the dialysate is drained from the abdomen and replaced with new solution. Peritoneal dialysis can be done in the home, requiring home delivery of supplies and monthly clinic visits for supervision. Several studies have shown that children treated with peritoneal dialysis have better coping skills and less depression than those on hemodialysis.