dialysis

[Lifestriver]

stage 5 kidney disease and at the point where I have to decide on which dialysis to go with--Home HD or PD. Would appreciate anyone on dialysis to say which one they decided on and experience with that type. Need help making decision.

[FelineFandom146]

Hello LifeStriver: I'm not on Dialysis yet, though with my eGFR at 10.9 I'm also in Stage 5 Kidney failure. Since I'm clinically all right and feeling fin my Nephrologist is not pushing me to begin dialysis/or transplant, yet. May I ask how you feel? Do you still feel good and functioning okay? You may not really need dialysis, yet. I was at Stage 3A for nearly twenty years then to Stage 3B for about ten years until one weak moment when I had a very painful UTI in 2020. My PCP put me on antibiotic, anti-inflammatory and anti-spasmodic, a cocktail of meds that no one with CKD should ever take my Nephro doc informed me afterwards. After that My eGFR dropped to Stage 4 for a couple of years and now for the last year I'm in Stage 5 with eGFR of 10.9 but no clinical or symptomatic need to rush into dialysis or transplant, yet. Eat a healthy diet and exercise. That is where I am now. I've also gone Whole Food Plant Based Vegan. No meats, no dairy, no oils, no nuts. If I can delay progression with diet, it's worth a shot. Good luck. Run everything by your Nephrologist, Dietitian, if you have one and research. Speak with your Pharmacist. They know more about meds than our physicians do and remember this: it is your body. No one knows it better than you do. Physicians don't know everything and do make mistakes that you'll pay for. And here in America, it is important to note that Nephrologists make a great deal of money for every patient they push onto dialysis whether the patient really needs it or not. Thinking is now split among those physicians saying not to rush patients until dialysis, that it is batter to wait, while others are still pushing patients into dialysis as soon as their numbers drop to a certain number. Note that rushing you into dialysis doesn't actually help you. It just extends your life and takes its toll on the body. It's interesting to note that in both the UK and Australia, patents don't begin dialysis until their eGFR is at 10 and how the patient is feeling, too.

As for when the day comes, I've researched and asked lots of questions from others who are on dialysis and I've chosen at home HD. I would have chosen PD but you can't do PD if you ever had any abdominal surgery. PD is easier for most people. With PD you won't need surgery to put in a fistula or graft into your arm and dialyze that way. I prefer transplant over dialysis but since that is severely limited I chose my form of dialysis. PD is done using your abdomen and allows flexibility. Here's some info to help you choose: kidney.org/kidney-topics/ch...

sciencedirect.com/science/a...

There are quite a few people on this site who are on dialysis and should be able to give you more insight than I can. Hope this helps. Stay safe. Stay hydrated.

[Bassetmommer NKF Ambassador]

The choice comes down to what will work best for you. It is a life style. I am on home hemo. It requires care partner. Some can do solo but it is a lot. I do 3 times a week. It means I do all my own set up. Heavy boxes of saline and dialysate have to be stored and carried to where you will do dialysis. The other supplies are extensive. Cartridges and hanging bags and other equipment. You have to keep on top of the inventory. You have to do maintenance on the equipment. Then you have to be able to set up each time you do dialysis. It gets easier over time. But just when you think it's easy, something happens. There are over 500 alarms you have to deal with. You have to be able to cannulate yourself or have your care partner do it. For some, that is the worse. For me, it was no big deal.

The advantage is it cleans your blood better than PD. It is gentler on the body than going in center. You can do it whenever you want. That is the best part. You are in your home, comfortable with things to make the time go buy. The bad part is when something goes wrong, and you do not know what to do. We do have tech support with my system, but sometimes the wait to get help is too late.

I choose HHD because of the freedom. I do it when I want. I can switch days and times as needed. I can skip if necessary and no one freaks out and tells me I am going to lose my time. I am comfortable, in my pjs with my husband and my dog. I can read or play games or even snooze. It is quiet. I can cannulate very easily so that is not an issue. I also wanted to be able to swim and I did not want something hanging out of my belly that can easily get infected.