If you are a pre-dialyzor or dialyzor who wants to choose the right type of dialysis, here are 3 quick secrets you need to know.

Secret #1: Two Basic Types Of Dialysis – 5 Flavors

Pre-dialyzors and dialyzors hear me closely on this secret: Choose your type of dialysis carefully.  You can do frequent and gentle dialysis in the comfort of your own home, or less frequent, but harsher dialysis at a dialysis clinic.  You need to know the effects of each on your time and your body.  Home dialysis comes in two flavors, hemo or peritoneal.  I will explain each of these in detail, so read on..

So, here's what this really means: the type of dialysis needs to fit your lifestyle and your abilities.  Are you able to do peritoneal or hemodialysis at home?  These are the choices that will give you the best health, the most freedom and have the least impact on your diet..

This secret is key because If you just take the first or “easy” option of in-center dialysis, you will have a very restrictive diet. You will feel terrible after each session, and you will, in all likelihood, lose any residual function you may have.  You want to maintain your residual function because, the more residual function you have, the less dialysis you will need!  And, your organs will be stunned, especially the heart and brain.  This can shorten your lifespan!.

My advice at this point is to find out all you can about the different types of dialysis, right now!  It will affect your life and overall well being.   Read the next two sections describing the different types of dialysis. It is very important to understand the impact each type of dialysis will have on your life. .

Secret #2: Peritoneal Home Dialysis – What The Heck Is That? 

The main idea with this secret is Peritoneal Dialysis (PD) is a form of home dialysis that relies on the peritoneum, a membrane in your abdomen that surrounds your organs.  A catheter is placed in your belly!  Dialysate fluid enters and exits the abdomen through the catheter, either manually,  via gravity, or automatically via a pump.  The peritoneum acts as a filter, as the blood comes through the peritoneum it encounters the dialysate which removes toxins and excess fluid.  The cleaned blood then passes back through the peritoneum and on to the rest of your body.

The manual version is done several times during the day.  The “automatic” version is done several times over night.  In either case, the dialysate fluid “dwells” or sits in your abdomen for some amount of time before it is removed, complete with toxins and excess fluid, and then replaced with fresh dialysate..

So, here's what this means to you.

It is important to know that a catheter is placed in your belly, usually just below the belt level. This catheter is a gateway to your organs and blood. Absolute cleanliness and sterile (aseptic) methods are required to avoid serious infections.  Many people are able to do this and live their life, but remember, these infections can be deadly!

Pros & Cons of PD

  • You can shower.
  • Using a cycler over night will give you your day back
  • Most people on PD feel good.
  •  Automatic sometimes causes drain pain.  Not everyone experiences it.
  •  Must be super careful with cleanliness.  Peritoneal infections are easy to contract.
  • The peritoneum will wear out.  The duration varies with the individual.
  • You cannot swim or bathe with the catheter (to avoid infection).
  • PD takes off a lot of protein.
  • So, you will need to eat lots of protein rich food that can be difficult to eat enough, especially if you leak protein in your urine.
  • PD may also remove too much potassium, if so, you will need to eat potassium rich foods!

Pre-Dialyzors and Dialyzors Need to Understand

This secret is key because PD is very gentle on your body and allows you to eat most anything you want, especially protein.  If you are able to sleep with a PD pump at the side of your bed, you will have your days free and be able to live your life again.

If you choose manual, you will have to “exchange” dialysate 3-5 times a day, depending on your size and dialysis needs.  An exchange consists of a dialysate bag hung on an IV pole.  The dialysate is allowed to drain into the peritoneum.  After about 4 hours, the fluid is drained from the peritoneum, and the process is repeated.  You can still, for the most part, go about your daily routine. You'll just have to find a time and place to exchange the dialysate..

My suggestion to you now is to Check out PD. It is a great choice if it works for you.  It works well for many people, it is gentle on the body, does NOT cause organ stunning and it gives you quite a bit of freedom and good health.  Talk to your doctor and nurses about the pros & cons of PD.  Ask to speak to other patients that are on or have been on PD.  .

Secret #3: Home Hemodialysis – An Excellent Choice

One thing is for sure, Hemodialysis at home is an excellent choice if you are able.   You will have a dialysis machine at home. In the U.S. it is usually a NxStage brand which is designed for home use.  It is much smaller than the machines used in the dialysis clinics, and easier to learn how to use.

Dialysis at home allows you to slow down the blood pump and to slow down the rate at which fluid is removed.  Doing this is MUCH easier on the body than the high rates used in dialysis clinics.  Your organs won't get stunned, it is easier on your fistula (an artery and a vein connected together), and you will feel ok when you get off the machine. You will be able to go on about your day or evening.  Home hemodialysis can either be done short daily, or nocturnal (overnight while you sleep).

Home hemodialysis (HHD) will require that you or a your partner insert 2 needles into your fistula, this is called cannulation. It is often the most intimidating part of the process, but it is worth working through it. Blunt needles are sometimes used for cannulation on “button holes”. Button Holes are analogous to pierced ears.  A needle track is created with sharp needles.  After several (5 or 6) days usage, a track is formed and blunt needles can be used. They are much easier and less painful than the sharp needles.

Training for HHD takes about two weeks at your clinic. Your nurses will teach you everything you need to know before they let you go home..

This is important to you because it means HHD can be done overnight (nocturnal) while your sleep 3 to 4 times a week or short sessions daily (Short Daily) 4-6 times a week.  HHD, with the correct prescription can give you as long a life as with a transplant.  If you choose nocturnal, you will have your days free and you'll likely feel like doing something!

Benefits of Home Hemodialysis

  •  You'll feel as close to “normal” as you possibly can without working kidneys.
  • Little or no diet restrictions.
  • Probably won't need blood pressure medication.
  • Blunt needles are much less painful than sharps.
  • As with short daily hemodialysis, you are in control!

This secret is critical to your success because  HHD has a very positive effect on your life.  In my opinion it is the best option short of a transplant (which can have its own side effects).  It can give you a good quality of life. That is why I am on HHD!

However, HHD is a serious undertaking and not everyone can do it.  You will need space for lots of supplies, PD requires the space too!  And, you will need space for the equipment.  You may need a partner.  Many people have a partner to help them, but it is not required.  My husband is a huge help to me.  But, I know several people who do it all themselves.  It depends on you!.

You should definitely take advantage of the education classes that many dialysis clinics offer when you are first diagnosed with kidney failure.  They will give you the nitty gritty details of each type of dialysis. If, they don’t give you the information, then ask for it, or find another clinic. Take advantage of the education, and ask as many questions as you can. Choose the type of dialysis that will have the least impact on your lifestyle.

Not everyone will act the same way when they finally learn these 3 types of dialysis secrets.  Just don't be the pre-dialyzor or dialyzor who puts all these advantages to choose the right type of dialysis on the shelf.  You earned this knowledge, so use it wisely. Become that pre-dialyzor or dialyzor who shakes their head in sorrow for the people who had to lose control of your life. If you want to choose the right type of dialysis, be smart about it.

My next article will be about Diet and Getting the Correct Prescription. Stay tuned! this is also very important to your life and well being.

Hey, One More Thing!

Before I forget, if you're a pre-dialyzor or dialyzor who wants to further improve your life, check out this blog article, Why Bother Tracking Your Diet at https://kidneydietcentral.com/kidney-diet-why-bother


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