User Tag List

Likes Likes:  7
Page 1 of 2 12 LastLast
Results 1 to 10 of 55

Thread: Dialysis choices

Hybrid View

Previous Post Previous Post   Next Post Next Post
  1. #1
    Join Date
    Sep 2013
    Location
    England
    Posts
    770
    Post Thanks / Like
    Mentioned
    28 Post(s)
    Tagged
    0 Thread(s)

    Default Dialysis choices

    I thought I'd start a thread specifically for dialysis options. Hopefully this thread will become a good starting point for people at Stage 4 renal failure who need to begin to decide which dialysis is best for them.
    I have only had actual experience of dialysis for a few weeks, over 20 years ago, so most of the following info is what I have recently read, rather than what I have experienced. So please feel free to correct me if anything is incorrect.


    When choosing dialysis there are 2 main options - Haemo and Peritoneal.
    Beyond that the next choice is - at home or in clinic/hospital.
    Beyond that it is - frequency and the choice of nocturnal or day time.


    There is a mass of information regarding the various options, so I will try to pick out some main points, but will try to answer any specific questions I don't cover.


    "Which is best?" is likely to be one of the first questions, but there is no one-fits-all answer. The correct dialysis should not only be the one that prolongs life, but also lets you live, socialise, work, etc.
    No current dialysis matches the performance of a living donor transplant. The best dialysis is that which mimics a kidney as close as possible. Considering a healthy kidney works quietly behind the scenes 24/7, the best dialysis (for prolonging life) would be if you were attached to the dialysis machine 24/7.
    This is obviously not practical. Therefore the best "realistic" dialysis is dialysis that happens frequently, for many hours.
    For this reason nocturnal dialysis, every night (or most nights) is usually a good choice.


    Pro and cons


    Heamodialysis at clinic/hospital.
    Pros - Some patients only feel safe when professionally trained nurses deal with dialysis.
    - If space is limited at home, there's no issue
    - Home is always home and a place to relax. Your home hasn't become a full time medical facility
    - Get to meet other dialysis patients
    - Usually get 4 days a week off dialysis completely (in reality this isn't good for kidneys though)


    Cons - Slower, more frequent dialysis has the best results. Hospital/clinic dialysis is the opposite. You are likely to get 3x4hrs/week. Therefore out of a 168hr week, your body only has the equivalent of 12 hours kidney function.
    - Food and fluid intake is restricted (often quite severely)
    - Usually need extra meds to combat the inefficiency of this method
    - With travelling, parking, waiting and preparation for dialysis, waiting to be "unpluged", etc, a 4 hours dialysis can take up most of the day.


    Peritoneal, Continuous Ambulatory Peritoneal Dialysis (CAPD)
    Pros - Done at home, or wherever there's a clean environment, so no trips and waiting at clinic/hospital.
    - The "exchange" is done 4-5 times a day, every day so results are good (less pressure on heart)
    - Fluid and diet is either not restricted or only mildly
    - No machines involved, which makes travel more accessible.
    Cons - 4-5 times/day (approx 40 mins), every day, is a big commitment
    - Peritonitis (infection) is a bit of a risk
    - Some people don't like having tubes hanging out of their stomach
    - The Peritoneal lining in your stomach is unlikely to manage this type of dialysis permanently (usually 3 years)


    Peritoneal, Automated Peritoneal Dialysis (APD)
    Pros - Done through the night, so you can get on with life during the day, every day, without using dialysis
    - Done at home, or wherever there's a clean enviroment, so no trips and waiting at clinic/hospital.
    - Done most nights, for long period, so results are good (less pressure on heart)
    - Fluid and diet is either not restricted or only mildly
    - Machine is quite small and portable
    Cons - May make sleep hard to achieve, especially the first few weeks.
    - Peritonitis (infection) is a bit of a risk
    - Some people don't like having tubes hanging out of their stomach
    - The Peritoneal lining in your stomach is unlikely to manage this type of dialysis permanently (usually 3 years)


    Haemodialysis at home.
    Pros - Can be done more frequently and during the night, giving best results and least strain on heart
    - No travelling and waiting at hospital/clinic
    - If you dialyse during night, you have every day to yourself
    - Not restricted on fluid/diet if you have frequent dialysis
    Cons - Using needles and high-tech machines at home can be daunting for some.
    - Some machines need to be plumbed-in, so may not be suitable for all homes


    I am due a home visit soon to discuss my options. If they have any relevant info, I shall add it to this thread.
    Diagnosed April 1995

  2. #2
    Join Date
    Feb 2013
    Location
    Israel
    Posts
    4,056
    Post Thanks / Like
    Mentioned
    26 Post(s)
    Tagged
    0 Thread(s)

    Default

    Thank you, Pete, for such generosity & kindness to share all these info with us. Not an easy decision to make... please update us what you decide and why. I keep you in my prayers ♡
    Alysia
    dx 2008


    Here, in this forum, I have found my sweet eternal love, my beautiful Phil.. :
    https://www.wegeners-granulomatosis.com/forum/threads/4238-pberggren-memorial-thread
    "You are my sunshine", he used to sing to me... "you make me happy, when skies are grey" I still answer him.
    Rest in Peace, my brave Batman and take care of your weggies from heaven, until we meet again.

  3. #3
    Join Date
    Sep 2013
    Location
    England
    Posts
    770
    Post Thanks / Like
    Mentioned
    28 Post(s)
    Tagged
    0 Thread(s)

    Default

    Thanks Alysia.
    Haemodialysis through the night, 6 times per week seems to be the most effective. But that is so long as your fistula works well. I often have problems with blood tests and cannula, so I'm not sure.
    I will definitely choose to dialyse at home and for long/frequent periods. So APD through the night, may be best for me. It is also fairly portable, which is important due to my many hospital appointments that are a long distance from home (i.e. I spend the night before close, or in the hospital grounds).
    Diagnosed April 1995

  4. #4
    Join Date
    Feb 2013
    Location
    Israel
    Posts
    4,056
    Post Thanks / Like
    Mentioned
    26 Post(s)
    Tagged
    0 Thread(s)

    Default

    Thanks for sharing, Pete. Sounds like you have found the better way for you. I hope the fistulla will cooperate. Please update us how is it going...
    Alysia
    dx 2008


    Here, in this forum, I have found my sweet eternal love, my beautiful Phil.. :
    https://www.wegeners-granulomatosis.com/forum/threads/4238-pberggren-memorial-thread
    "You are my sunshine", he used to sing to me... "you make me happy, when skies are grey" I still answer him.
    Rest in Peace, my brave Batman and take care of your weggies from heaven, until we meet again.

  5. #5
    Join Date
    Sep 2013
    Location
    England
    Posts
    770
    Post Thanks / Like
    Mentioned
    28 Post(s)
    Tagged
    0 Thread(s)

    Default

    Just been catching up with my emails and noticed one from yesterday - from my nephrologist's secretary. It stated that my latest bloods showed further deterioration from 18% function to 14%
    15 % or less is Stage 5 Cronic Kidney Disease / End Stage Renal Failure and requires dialysis.

    I was SO hopeful that my kidneys would stay above 15% for another 10 months (I could pursue a transplant then if I stay in remission). I need the bloods repeated, which I think will be tomorrow. If no improvement then dialysis will be very soon. I've actually felt worse the last 5 days so I'm expecting the worse.
    Diagnosed April 1995

  6. #6
    Join Date
    Mar 2012
    Location
    Suburban Columbus, Ohio, USA
    Posts
    2,171
    Post Thanks / Like
    Mentioned
    12 Post(s)
    Tagged
    0 Thread(s)

    Default

    Sad to hear the news, Pete. Hope all goes well going forward.
    Pete
    dx 1/11

    "Every day is a good day. Some are better than others." - unknown

    "Take your meds as directed and live your life as fully as you can." - Michael Chacey, MD

  7. #7
    Join Date
    Jul 2010
    Location
    see map location
    Posts
    4,137
    Post Thanks / Like
    Mentioned
    7 Post(s)
    Tagged
    0 Thread(s)

    Default

    Quote Originally Posted by gilders View Post
    Just been catching up with my emails and noticed one from yesterday - from my nephrologist's secretary. It stated that my latest bloods showed further deterioration from 18% function to 14%
    15 % or less is Stage 5 Cronic Kidney Disease / End Stage Renal Failure and requires dialysis.

    I was SO hopeful that my kidneys would stay above 15% for another 10 months (I could pursue a transplant then if I stay in remission). I need the bloods repeated, which I think will be tomorrow. If no improvement then dialysis will be very soon. I've actually felt worse the last 5 days so I'm expecting the worse.
    Sorry to hear that.
    Knowledge is power! Wisdom is using it to make good decisions!

  8. #8
    Join Date
    Feb 2013
    Location
    Israel
    Posts
    4,056
    Post Thanks / Like
    Mentioned
    26 Post(s)
    Tagged
    0 Thread(s)

    Default

    Quote Originally Posted by gilders View Post
    Just been catching up with my emails and noticed one from yesterday - from my nephrologist's secretary. It stated that my latest bloods showed further deterioration from 18% function to 14%
    15 % or less is Stage 5 Cronic Kidney Disease / End Stage Renal Failure and requires dialysis.

    I was SO hopeful that my kidneys would stay above 15% for another 10 months (I could pursue a transplant then if I stay in remission). I need the bloods repeated, which I think will be tomorrow. If no improvement then dialysis will be very soon. I've actually felt worse the last 5 days so I'm expecting the worse.
    I am sorry, Pete. I keep you in my daily prayers & I ask my beautiful dr. Phil to help you from his good place in the presence of God ♡

    Question, which also reflects my wish for you: you said that your wg is active now. Is it possible that once you will beat it to remission, the kidney's functions will get better ?
    You have being on dialysis 20 years ago but you have recovered from that need. Is it possible again ? And if this is the issue, then the wg treatment is the most critical thing, isnt it ? What treatment are you on ?

    Sorry if I ask too much or stupid questions... trying to think about more possibilities.....
    Alysia
    dx 2008


    Here, in this forum, I have found my sweet eternal love, my beautiful Phil.. :
    https://www.wegeners-granulomatosis.com/forum/threads/4238-pberggren-memorial-thread
    "You are my sunshine", he used to sing to me... "you make me happy, when skies are grey" I still answer him.
    Rest in Peace, my brave Batman and take care of your weggies from heaven, until we meet again.

  9. #9
    Join Date
    Apr 2011
    Location
    Olympia, Washington
    Posts
    6,928
    Post Thanks / Like
    Mentioned
    12 Post(s)
    Tagged
    0 Thread(s)

    Default

    Glad to hear a pretty positive report, Pete! I hope you won't need a transplant, but what a blessing to have your dad as a possible donor. All the best to both of you!

    Sent from my MotoE2(4G-LTE) using Tapatalk
    Anne, dx'ed April 2011

  10. #10
    Join Date
    Feb 2013
    Location
    Israel
    Posts
    4,056
    Post Thanks / Like
    Mentioned
    26 Post(s)
    Tagged
    0 Thread(s)

    Default

    I found this one to cheer you up gilders and the others...

    https://troab.com/worlds-first-bioni...ust-two-years/
    Alysia
    dx 2008


    Here, in this forum, I have found my sweet eternal love, my beautiful Phil.. :
    https://www.wegeners-granulomatosis.com/forum/threads/4238-pberggren-memorial-thread
    "You are my sunshine", he used to sing to me... "you make me happy, when skies are grey" I still answer him.
    Rest in Peace, my brave Batman and take care of your weggies from heaven, until we meet again.

Page 1 of 2 12 LastLast

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •