Peritoneal vs. Hemo Dialysis: One Patient's Experience

Author's note: This article is based solely on my experience with both mentioned forms of dialysis treatment. Each individual situation is unique and patients should consult a physician before making any decision regarding treatment of End Stage Renal Disease.

When faced with treatment options, many End Stage Renal Disease (ESRD or kidney failure) patients choose in-clinic hemodialysis out of fear of the unknown. Others are drawn to the comfort of having professionals in charge of their care. For me, it was a combination of the two. In my haste, however, I failed to do sufficient research into the peritoneal dialysis (PD) option. There are pros and cons to both methods but ESRD patients owe it to themselves to be fully educated in all methods of treatment before making a final choice, I discovered that the peritoneal option was the better choice for me, but only after having a graft for hemodialysis access surgically inserted in to my forearm... a decision I would later regret since this access is now a permanent fixture.

WHY PD WAS RIGHT FOR ME

Hemodialysis is taxing on the body in a number of ways. I often left therapy feeling weak and practically unable to function for the remainder of the day. This feeling of weakness was compounded by my struggle to control fluid intake. The more fluids consumed, the greater the need for removing it during treatment, the greater the strain on the heart and body. This was my biggest challenge while on hemodialysis. I would often gain double... some times three times the recommended fluid weight between treatments. My penchant for drinking large amounts of water before my diagnosis was difficult if not impossible to shake. Peritoneal therapy offers less restriction of fluid consumption or, in many cases, none at all. In addition, potassium intake is not restricted as it is with hemodialysis. Regarding dietary restrictions, learning just what you should and shouldn't eat is a never ending process. There seems to be something new to learn each day. Reading labels and researching specific foods before each meal is a bit cumbersome. WIth PD, these dietary restrictions are less stringent.

My second major challenge while on hemotherapy was was coping with being confined to a chair for three to four hours with little to keep me occupied aside from a television. As a relatively young ESRD patient, I still led an active lifestyle which included keeping up with my two-year-old son (a full time job in and of itself). I often found myself watching the clock which added to my anxiety. With peritoneal treatment, the patient is largely in charge. Treatment time is flexible and in most cases can be done overnight while sleeping using an automatic cycler. Freedom is a beautiful thing. I have more of it on PD.

THE RISKS AND DRAWBACKS OF PD

Peritoneal dialysis is not right for everyone. Potential patients should consult with a nephrologist. Surgery is required to place a catheter into the abdomen. The most common complication of PD is Peritonitis or infection of the Peritoneal Cavity which occurs when the catheter is contaminated. This can be prevented by following all steps and adhering strictly to sanitary procedures. The process of attaching to the cycler or manual ultra bag is requires meticulous attention to detail. There is a vast array of supplies required to perform treatments at home. Most of these supplies are delivered to your home but require substantial storage space.

Despite these challenges, I have discovered a new confidence with PD. I really like the fact that I am in control. Being able to consume fluids at a pace of my choosing has relieved me of a tremendous source of stress. While PD my not be for every one, it was definitely the best option for me. There are no needles and I value the extra freedom and the time I can now spend with my family and pursuing professional goals. I strongly recommend potential patients take the time to fully research all options before making a decision. It will be time well spent and will aid you in making the right choice for your lifestyle. While kidney transplant is the ultimate goal, PD provides me with the best treatment option in the interim.