Treatment Overview

Your Treatment Choices

When it comes to treating end stage renal disease (ESRD), one size does not fit all. You can choose from our different types of treatment options to find the one that best suits your health and lifestyle needs.

When is treatment needed?

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

  • Your symptoms
  • Other health problems you have
  • How much kidney function you have left
  • Your nutritional health to help know when you need to start treatment. Your doctor should give you a simple blood test to estimate your glomerular filtration rate (GFR). This tells how much function your kidneys have

How is GFR calculated?

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.

How to choose the right treatment

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.

How do I know which treatment is best for me?

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:

  • Medical condition
  • Lifestyle
  • Personal preference

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

  • Following your treatment schedule
  • Following your special diet
  • Taking all your medicines as instructed.

Following your treatment plan will help you live longer and feel better.

Hemodialysis

What is hemodialysis?

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.

Where can I have hemodialysis treatment?

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.

What is required to do hemodialysis at home?

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.

Are there different types of home hemodialysis?

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.

Peritoneal Dialysis

What is peritoneal 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.

Are there different types of peritoneal dialysis?

Yes. The major ones are:
  • 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.

Kidney Transplant

What is a kidney transplant?

A kidney transplant is an operation that places a healthy kidney from another person into your body. The kidney may come from someone who has died or from a living person who may be a close relative, spouse, or friend. It can even come from someone who wishes to donate a kidney to anyone in need of a transplant. Your new kidney will be placed in your lower abdomen and connected to your bladder and blood vessels. The transplant operation takes about 3 hours and you will be in the hospital for about 5 to 7 days. After the transplant, you will need to take special medications to prevent your body from rejecting the new kidney. You will have to take these medications for as long as you have the transplant. Many patients prefer a transplant over dialysis because it gives them more freedom, allows for a less restricted diet and may improve the quality and length of life. A kidney transplant is a treatment, not a cure. A person with a kidney transplant still has kidney disease, and may need some of the other medicines they took before the transplant.

How can my family and I cope with kidney failure?

You and your family may have difficulty accepting the changes in your lives caused by kidney failure, which can be a lot to handle. You may have feelings of frustration, guilt, denial, anger and depression. You and your family may find it helpful to share your questions and concerns with each other and with people who are willing to offer support. These can include close friends and members of the healthcare team. The social worker at your dialysis center is trained to provide counseling to help you make the transition to dialysis or transplantation. Some of the biggest changes are:
  • 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.
 The healthcare team (social workers, dietitians, doctors, nurses, technicians, and other staff) are trained to help you make these changes and to help you understand all areas of your care.

Is it normal to have fears about beginning treatment?

Yes. It is normal to have concerns about how you will feel, whether the treatment will hurt, what the staff and other patients will think of you, and how long you can live with the disease. The following steps can help you cope with your feelings:
  • 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.

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