(PD) uses a patient’s peritoneal membrane as an alternative source for dialysis, as opposed to the membrane in the artificial kidney. It requires placement of a catheter into the abdominal cavity, and repeated instillation of sterile dialysate, a dwell time, and drainage of dialysate, commonly known as an “exchange.” Several PD options are available. The most common is continuous ambulatory PD (CAPD), during which the patient performs 4 to 5 exchanges daily. Continuous cycling PD (CCPD) utilizes several exchanges administered by a programmed machine (cycler), typically every night, with one long dwell during the day. CAPD and CCPD can also be used in combination when needed. PD is the dialysis modality used most often on children.

Nocturnal hemodialysis is usually done for 6 -10 hours in-center, 3 to 6 nights per week while patients sleep. Or from 5 to 12 hours at home 5 to 7 nights a week. In some locations, dialysis professionals monitor the home treatment by telephone modem or the Internet. With nocturnal hemodialysis, patients seem to exhibit fewer adverse symptoms during treatment and experience better appetites, energy levels, and quality of life. There are also fewer dietary and fluid restrictions.

Kidney transplantation is a treatment rather than a cure for kidney failure. This is an elective procedure rather than an emergency or life saving procedure. For medical reasons, not all patients are eligible for kidney transplants. Some conditions put patients at risk for severe complications. Unless medically contraindicated, a working kidney transplant is the treatment goal for all pediatric patients.