Type 1 diabetics on Perotoneal Dialysis

[Aarti]

Please share your experiences e.g positives and negatives ,problems faced. Need to choose between HD and PD

[lmunchkin]

Asrti, so sorry this has not been answered for you, so many threads on here, that it is hard to keep up with at times. So please forgive us, it was just overlooked.

Well, we have done both of these modalities.  Both are very good choices.  PD is a "mindful" dialysis, in that you have to be mindful of everything you touch when connecting or disconnecting. Sanitary conditions is Always relevant with this modality. Once you learn that, it can be an excellent form of Dialysising.  My husband is diabetic.  And when he did PD, his BS ran high, so we just gave shots to accomodate it, but it was definately harder to maintain his blood sugars.  Thus he has had several amputations since doing PD, but it wasnt the PD necessarily as much as it was trying to control his blood sugars.  Looking back, I would not have done PD because of the diabeties.

Home hemo has really been a blessing for us. Since doing (NxStage) at home, his labs have been great.  He doesnt need all those meds that he use to have to take, now they are "As Needed" type meds.  He hasnt been in a hospital since Feb 2010, and that is a Godsend!!!!!  Hemo is a little more difficult to learn, but after learning PD, I knew I could do hemo too!  The only difference is one is systemic and the other is through a cavity. Now with PD you have a catheter inserted, but with hemo, he has a fistula.   The fistula is his natural veins but the PD cath is a foreign object, so the chances of infections are increased with PD.  But if sanitary practices are used, you can do it for a long time.

Don't know if this helps or is what you wanted to know, but it is a brief synopsis of the two!

God Bless,
lmunchkin

[Kammie]

Asrti,
My personal experience has been with PD. 

My nephrologist suggested it for a couple of reasons.  One, I am a single mother of a mentally handicapped son and being 'away' so much for HD would be hard for me.  Also, because I live 'alone'..they didn't want me doing the home hemo because I supposedly need another person in the home in case I had a problem of some kind.

I have been on the PD for about 9 months now and other than the obvious 'I Hate Dialysis'..LOL..it has worked great for me.  I do feel bloated alot, and have developed a 'beer gut'..but the ability to do my dialysis at home..at night while I sleep..has far outweighed those things. 

I am, by nature, a very 'clean-freak' kind of person..and with PD you kind of have to be.  The risk of infection is high, but I always, always take all precautions I was taught (gloves, mask, etc) and to date have had no issues at all.

Best of luck to you which ever you decide!

[justjen321]

Hey hey Aarti!

My husband is not Type 1, he is Type 2, but for the purpose of this question, I think they are pretty much the same.

When we first began, out doctor strongly recommended PD. We did that for just about a year before switching to home hemo. My observations from the two:

PD -

Easier to learn to do at home
Pretty portable with planning for trips
Increases your calorie intake each day before you ever put food/drink in your mouth
Is more difficult to control blood sugars on
Requires much more sterile procedures for hook up and disconnect
You will have a tube with a transfer set hanging from your body at all times
You cannot swim in a pool or get in a hot tub (although you can go in the ocean)
You'll have a LOT of supplies in your house

For my husband, who is already considered obese, we had to use 4.25 bags pretty often (more glucose, more calories, and worse on your membrane). This caused some weight gain for him.

Home Hemo

Much more difficult to learn in the beginning
You get more control over how much fluid you remove
You can do it nocturnally if you choose, which, for many hemo patients, clears better and can mean the end of taking binders.
Requires less 'sterile' conditions, but more 'skill' to get hooked up
For the squeamish, it might not be okay. You will see blood in the lines, and in the 'kidney'.
Is slightly less portable due to size, but absolutely IS portable.
A little less supplies.

I probably don't have it all there. But my husband FEELS better and is on less meds with Home Hemo. He's also MUCH more able to regulate his blood sugars on this modality. For me, if I was choosing for him all over again, I would choose hemo.

Jen