Hi everyone, I was diagnosed with chronic kidney disease quite a few years ago. My kidney function is now at 28%. My kidney specialist says I am fine for now but heading for dialysis. I wanted him to tell me about the different types of dialysis. He is not very forthcoming. I live in a house by myself and wonder if it is possible to do dialysis in my home by myself. I also suffer from bi-polar II mental disorder. I was on lithium for 30 years. Now am off of it. This hasn't helped my kidneys. I am also an insulin dependent diabetic. My sugar levels are very good, blood pressure, potassium level also good. I do very well on my diabetic diet. How do you implement this with a kidney friendly diet? Would like to know more about about everything related to chronic kidney disease.
I must add that I am very tired lately. This creates many limitations which can be hard to swallow. I am almost 67 years old. I guess this doesn't help.
Hi Corrie. I don't know much about other types of dialysis, but I have been on Peritoneal Dialysis for about a year. I chose it because it was a smaller machine, I could do it at home and easy to take it and visit family. It might be something you can ask your doctor about and they can tell you more.
I have posted on this subject several times in the past explaining the two different types of dialysis both procedures for Hemo-dialysis and peritoneal dialysis so the information is there if you want to take a look at it you can go back to my posts and read them.
Several things to know. The first is not everyone is a candidate for dialysis and peritoneal dialysis requires a lot of effort and dedication on your part. Where as hemo dialysis done in a clinic you go in sit down and someone else does all the work for you. There are drawbacks and limitations to both so you will need to discuss with a qualified doctor and a nurse to see what you feel comfortable with and what they feel comfortable with you being able to do.
Some people do not qualify for peritoneal because of the placement of the catheter and scaring or previous surgeries or the persons ability to care for themselves and to maintain a strict regiment of cleanliness and sterility. There are other factors to consider like animals that may live in your home and various other things too many to mention on here.
The hemo dialysis a fistula is surgically placed in a location of your body usually the arm unless no viable veins and arteries are available and it takes about 6 months for the fistula to heal and form as what they do is hook a vein to an artery to expand the area so needles can be easily inserted and made accusable. This is called the access port.
Peritoneal dialysis is a catheter placed in the lining of your stomach normally done under general anesthesia and it takes about 11 or 12 days to heal before use. A lot of boxes are delivered to your home once a month and these contain the fluids used to clean your system out each night. Some people also do manual fills and drains during the day That will be up to the doctor or in this case the nephrologist to decide what he or she thinks will work for you based on lab tests. It is a trial and error things and takes a few months to get to a point your comfortable with and cleans your toxins out. During this time you go in once a month and get lab tests and adjustments to your fluid prescriptions and medications. Such medications like Lasix for water retention and perhaps blood pressure medicine as well as throid medciations and a few others.
Your kidneys to a whole lot for you and not just clean your blood. They are directly responsible for your iron levels in your body and as kidney function goes down the thyroid goes nuts trying to compensate for what your body is lacking and it will need the thyroid medication to chemically shut the thyroid down to keep your bones from forming calcium growths on them. Like I said your kidneys do a whole bunch of things.
The being tired thing is the need for dialysis. Once you get on dialysis the tiredness with subsides but it does take a while. In the meanwhile you may have swelling of the lower limbs do to water retention but Lasix can fix that.
You can live a normal life on either dialysis however peritoneal dialysis has a lot less restrictions on fluid intake where hemo you are drained and filtered once every 3 days so the toxins build up from day one until drained out on day 3. Peritoneal your cleansed every night or when ever you fill with fluid and drain so toxins do not get a chance to build up like on hemo.
Thank you Pete for all the information. It is much appreciated. I guess this may be different for everyone but at what level of kidney function will you need dialysis. I am currently at 28%.
I am also tired because I suffer from bi-polar II. I am on about 5 psychiatric drugs to keep me stable. Every afternoon I sleep from about 1 to 2 hours depending what activities I have been doing. I need to do this to function every day. I am still able to sleep at night.
Well most doctors at least here in the states get you into the program at around 30 GFR or slightly less. The idea is that they want to get you while you have some kidney function left especially if you might be a candidate for a transplant. The idea is to use dialysis as a stop gap until a kidney becomes available.
Most doctors have an end game in otherworld's they have a plan for your future. Although some patients are not able or will qualify for a transplant. In that case the end game is dialysis.
You must qualify for a kidney transplant but the recipient which is you and the donor have to pass strict guidelines and a lot of things can disqualify a person from the transplant list so as I said it may not be an option for those people but dialysis can last a long time if the patient is careful and attentive and very clean and follows the safety guide lines. It can offer a fairly normal life style.
Just like the drugs you take for you psychological ailments you have to follow strict gude lines for them to be effective. Since you are a nurse and have been on meds yourself for a long time you are familiar with the protocol and with dialysis's it is the same way. You train, learn, demonstrate and then preform the procedures yourself or with the assistance of a nurse depending on the route you go.
But in essence your at the point now where dialysis is becoming a necessity short of a transplant to maintain a healthy life style. The sooner you get on dialysis the better you will feel.
I know for myself I started looking at dialysis at 30 GFR and finally got approved and on it at less then 20 GFR. Lie I said before the idea is to get on it while you still have some kidney function left.
Shirley either dialysis will help you with the kidney failure. It is hard for me to say which way is best for you. I kind of think with older people hemo may be the way to go as it is a regiment set by the clinic and you go in every 3 days and someone else does it for you.
The peritoneal you do on your own at home and requires some work involved with it. The home hemo requires a second care giver which some people do not have in a case of a drop in blood pressure. When this happens the machine has to be turned off to let the blood pressure rise before you can continue..
Yes I do still drive and I am 54 this year but like anything getting older causes issues for the eyes too like myopathy that requires more light to see clearly or at least cheater glass I call them which are not prescription but over the counter ones to help read. Even for some people to drive but again check with your eye doctor on that. There could be other complications especially with diabetics which is the most common cause of kidney failure and they may have other eye issues like cataracts.
I don't think there is a gauge on 15 percent for dialysis that says 15 percent is all you can get but in reality a person can survive on 20 to 30 percent function but it can become hard on the body and damage other organs having poor kidney function.
The real bniefit to peritoneal is the not so tight food and water restrictions because your taking fluid off every day with it unlike Hemo which your only taking fluid off every 3 days.
Well congratulations on deciding to do the peritoneal dialysis. I know you have been on the fence fro a while as to which way to go. I am proud for you. Now you have a plan and direction and that will make all the difference in the world with attitude going into this.
You and I have been chatting in here for over a year probably closer to 2 years if not more.
We have discussed, cussed and rehashed the different choices and ways to go, over and over again. It is good to have people to chat with about something like this. People that have had the experience can bring so much knowledge, enlightenment and comfort to those just getting started. That is why I spend so much time on here answering questions.
I know how I was in the beginning scared to death of the unknown. It always helps to talk to people that have been thru it. Knowledge is powerful tool. When you can go into something already knowing what to expect it reduces the fear and anxiety that accompany something like this.
Once again congratulations on choosing PD. I think in the long run you will be happy you did.