Why Do People Need Dialysis?

People need dialysis when their kidneys begin to fail. This is called End Stage Renal Disease (ESRD) or Chronic kidney disease (CKD). The terms are used to described people with decreased kidney function. This happens most often for people with Hypertension (HTN) or diabetes type I or type II. There are other illness like polysitic kidney disease that can cause your kidneys to fail as well. It is important to work with a nephrologist to plan your treatment. Premier Dialysis will work with your current Nephrologist, or help you find one!

Once someone enters (CKD) Stage 5, they are eligible to begin dialysis. In most cases people are afraid to start dialysis, and put off until the “crash into dialysis.” This can present as a metallic taste in the mouth (uremia) or other side effects such as general naseua for extended period of time. Most patient end up in the ER by putting off treatment and hence the term “crashing into dialysis.” The purpose of Premier is to educate and help people understand that they have many options for their dialysis, and WE think home peritoneal dialysis provides the best opportunity to have the least impact on your life via early identification and planning with your Kidney doctor (Nephrologist) We will help you through every step of this process to take the worry out!

Five Dialysis Options

Intermittent Peritoneal Dialysis

This specialized dialysis treatment utilizes a manual exchange or (CAPD) once daily. The solution sits in the belly from 10-20 hours, during which time you will not be connected to any cyclers or machines! Intermittent Dialysis keeps you living the life you are used to living before your diagnosis. Premier specializes in this treatment and have trained and maintained over 55 patients with this treatment, please see our testimonials for more info.

Advantages: Helps PRESERVE the patient’s current renal function, which takes around 10-20 minutes to perform daily. Fewer supplies are required in the home. Diet is open to more of the foods the patient likes (in moderation, our dietician will help cater a diet for your lab values). Fewer supplies are needed, which frees up space in your home. You do this seven days a week. This is an advantage because your kidneys work 24/7. More frequent dialysis, especially very quick painless needle free dialysis, is better for you. Imagine working out seven days a week!

Disadvantages include: some patients will not qualify for treatment or get the complete electrolyte removal needed or lack of urine output. CONSULT YOUR PHYSICIAN OR OUR PHYSICIAN TO DECIDE IF THIS TREATMENT IS RIGHT FOR YOU! If your physician is not familiar with this treatment, we are here too help.

Automated Dialysis (APD)

This treatment involves using an automated cycler to perform dialysis treatments. During the evening, while you sleep, the cycler fills your abdominal area (PD membrane) with fluid and it automatically drains out. In the morning you wake up and throw away empty bags. This treatment also helps to maintain your residual renal function.

Advantages: keeps you urinating, is seven days a week! You can eat and drink more than hemodialysis. Captures residual functions. Easier to travel and take then setting up appointments in other cities for out patient hemodialysis.

Disadvantages: Takes up more space. (APD) PD takes more boxes and supplies, so you will need enough room. to store items. Attached to the cycler for the evening (with a 20 ft cord, meaning you can easily get up and use bathroom).

2. Hemodialysis (In-Center)

Hemodialysis is the most common type of dialysis. 97% of those with End Stage Renal disease have this form of treatment. Two needles are placed in an access created in the arm. One needle removes the blood from the body and pushes it through the dialyzer to clean the blood. Once the blood is cleaned, it is returned free of toxins and placed back into the body. It requires three treatments weekly at a facility for three to five hours. Advantages include not having to keep supplies in the home, and having a nurse or tech take care of you. Some disadvantages include: cramping, blood loss, decreased urine output, and bigger issues with electrolytes since you only dialyze three times a week

3. Home Hemodialysis

Home Hemodialysis is the same treatment you would receive at the dialysis clinic, but you do it in your home. The machine is smaller, and takes up much less space than an in-center, and water is cleaned on demand. Typically patients run two to three hours a day, five days a week. Benefits include not traveling to the clinic, increased control over treatment, and ability to eat and drink more foods (in moderation). Disadvantages include; storage space in home, a partner is required to monitor your blood pressure, and two additional days of dialysis vs the outpatient clinic.

4. Transplant

Kidney transplant is when a healthy kidney from either a living or deceased donor is placed inside your body to take over the work your own kidneys can no longer do. Longer life expectancy is just one benefit of kidney transplant. Whether you are newly diagnosed or have been on dialysis for years, transplant should be considered as an option and explored with your nephrologist and renal care team.  At Premier our main goal is to get EVERYONE on the transplant list.

5. No Treatment

Some people may choose not to treat their end stage renal disease. This option focuses on comfort care. Your nephrologist will educate you and your family on end of life care and what to expect moving forward.