Your doctor will help you decide when you need to start treatment. This decision is based on:

Your doctor can estimate your GFR from the results of a simple blood test for creatinine. Creatinine is a waste product of your body’s muscle activity. Your kidneys usually keep the level of creatinine just right. Your creatinine result is used in a math formula with your age, race and gender to determine your GFR. If your GFR falls below 30, your doctor should give you information about treatments for kidney failure. If your GFR is below 15, you will need to start one of these treatments soon.

Remember that you’re not stuck with a particular treatment option for life. The treatment that’s right for you right now, may not be tomorrow, and you can always speak with us about changing.

The two treatments for kidney failure are dialysis and kidney transplantation. Two different kinds of dialysis can be done— hemodialysis and peritoneal dialysis. Each type of treatment has pros and cons. As you find out more about each one, speaking with your doctor and your family can help you decide which treatment is best for you.

Your decision should be based on many things:

No matter which treatment you choose, you need to make a commitment to follow your treatment plan. This involves:

Hemodialysis is a treatment that removes wastes and extra fluid from your blood. During hemodialysis, your blood is pumped through soft tubes to a dialysis machine where it goes through a special filter called a dialyzer (also called an artificial kidney). As your blood is filtered, it is returned to your bloodstream. Only a small amount of blood is out of your body at any time. In order to be connected to the dialysis machine, you need to have an access, or entrance, to your bloodstream. Treatments are usually done 3 times a week. Each treatment lasts about 3 to 5 hours.

Hemodialysis treatments can be done at home or in a dialysis center. Dialysis centers may be located within a hospital or in a separate facility. You and your healthcare provider will decide which place is best, based on your medical condition and your wishes.

Your home must have enough space for the equipment and enough water drainage and electric power to operate the dialysis machine and water purification unit. You will also need a dialysis care partner. Usually this is a family member or friend, but may also be someone you hire to assist you. You and your partner will be trained in how to do hemodialysis at home.

With home hemodialysis, you will have 3 different types of treatment schedules to choose from. These choices are:

• Conventional home hemodialysis: Treatments are usually done 3 times a week, and each treatment lasts about 3 to 5 hours.
• Short daily home hemodialysis: This involves more treatments each week for shorter periods. For example, you might do 6 treatments a week (compared with the usual 3). Each treatment would last about 1½ to 2½ hours. Many people feel that their quality of life improves with this method of dialysis because they sleep better and have better control of blood phosphorus levels, blood pressure and anemia (low red blood cell count).
• Nocturnal (nighttime) home hemodialysis: This involves long, slower treatments, which are done during the sleep hours, usually for 6 to 8 hours. Many people sleep better and have better control of blood phosphorus levels, blood pressure, and anemia with this method of dialysis.

In peritoneal dialysis (PD), your blood is cleaned inside your body, not outside your body. The lining of your abdomen (the peritoneum) acts as a natural filter. A cleansing solution, called dialysate, flows into your abdomen (your belly) through a soft tube called a PD catheter. The PD catheter is placed during minor surgery. Wastes and extra fluid pass from your blood into the cleansing solution. After several hours, you drain the used solution from your abdomen and refill with fresh cleansing solution to begin the process again. Removing the used solution and adding fresh solution takes about a half hour and is called an “exchange.” Peritoneal dialysis can be done at home, at work, at school, or even during travel. Peritoneal dialysis is a home-based treatment. Many people who choose peritoneal dialysis feel it allows them greater flexibility and independence.

• Continuous Ambulatory Peritoneal Dialysis (CAPD). With CAPD, you do the exchanges yourself 4 to 6 times a day.
• Automated Peritoneal Dialysis (APD). With APD, a machine called a cycler does the exchanges automatically once you have set up the equipment. APD can be done while you sleep. However, if you do APD, you may also need to do 1 or 2 exchanges yourself during the day to make sure enough wastes and extra fluid are being cleared from your blood.

• getting used to a new routine with peritoneal dialysis or hemodialysis
• following your diet and nutrition plan
• taking all your medicines exactly as instructed by your doctor (including anti-rejection medicines if you have a transplant)
• continuing with your work, studies, school, family commitments, and hobbies.

• Ask your healthcare provider if you can visit a dialysis center. Visiting the center can help you make choices.
• If you are interested in a kidney transplant, ask your healthcare provider for a referral to a transplant center. Set up an appointment to visit with the staff and make a list of questions.
• Speak to others who have been through the same experience.
• Discuss all your concerns with the healthcare team here at Purivo Dialysis Center.