How did you decide on your dialysis method/modality?

[Kbristow]

A friend will be starting dialysis and wants to know what are some reasons a patient choose their modality. I shared with her how I decided on PD so I'm not as familiar with the in-center hemo experience. She is a full time caregiver for a family member at home and isn't sure how she will find care for him while away at dialysis. On the other hand, she doesn't feel comfortable not having someone at home to help her do PD or just be available in case of emergency. Can you share how you decided on your dialysis modality, and if you ever switched?

[Bassetmommer]

If she is not confident to do home hemodialysis HHD or PD, then in center is the only choice. I am in the process HHD, and I choose that because I want to schedule my dialysis when I want to, and I am also confident in my abilities to manage.

[Hidden]

There is a website called Mykidneylifeplan.org that may be of some assistance. I suspect there are other similar site options as well. Personally, I chose home peritoneal dialysis (PD) and had 24 hour support from my home dialysis team by phone. At first, PD seems a little overwhelming but once you establish a regular routine, it is very doable and I appreciated not having to go to the hospital for hemodialysis (HD) especially during these past few years. I wanted to be as independent as possible and I wanted daily dialysis because I felt it would be more gentle on my body. Home HD has become an option that some people are choosing, too. Either a fistula in the arm or a PD catheter procedure in the tummy is required for dialysis access, which is also part of the decision making process. Best wishes to your friend!

[KidneyCoach NKF Ambassador]

This is a good start. mykidneylifeplan.org/

[checkman]

I was kind of talked into going on PD by my 1st DR. That's ok.. but boy oh boy I had no idea of the work that went into doing that. Everybody talks about making sure you have enough room for all the supplies, that's fine until you really start the process. Carrying heavy boxes and bags of dialysate, especially if you have steps. But the most work involved is getting rid of all the trash that goes along with that. A LOT of work, especially when you have no help. I assume home hemo would be pretty much the same. Although I would never trust the tap water that has to be used in home hemo due to all the toxic chemicals that you don't know about coming from your tap. ewg.org has a tap water db by zip to show you this information. In center hemo I'm in and out in 3.5 hours 3 days a week I spent almost the same amount of time taking care of the trash on PD. That's 10.5 hours/week, no big deal. I spent A LOT more of my time dealing with PD and all that goes with it.

[LeesKees_NJ in reply to checkman]

I have to agree with you . I did Solo Home Hemo and the maintenance of the machine, making the fluids and keeping track of everything was DOUBLE the work of going into the center. I did it for a year. FYI - they test your water thoroughly and repeatedly to make your water supply is good enough for Home Hemo.

Now, I go to the center and do my 3 hours, 3x a week and I'm done. I don't worry about anything any longer., I don't have to clean the machine or order supplies. I thought having the flexibility of schedule treatments would be worth it but I found that going in at 5:30 am and banging it out first this every Tues, Thurs, Sat morning is much much easier on me and incredibly less stressful.

PD was not an option for me I have polycystic kidneys and liver and the crowding issue made it impossible for me to take in the fluid needed for PD to successfully clean my blood.

[bumblebee_tuna]

Kbristow, your friend should look into CAPD, this way she would not be tied up to a machine It looks like she is home most of the time so doing day time exchanges should not be a big issue.