Combine pd and hemo

[orion]

I my catheter tunnel infected with mrsa and never really cured .
I want to do the partial catheter replacement but doc said the opportunity of reapted infection is very high.
Now doc ask me if I can pull out the pd and do the central catheter for a awhile, after several months when my infection cleand then do the pd again.
But I prefer do the av fistula first, then do the partial cathter ,if failed I still have fistula I can do pd in the future ,if success, I can have fistula as a backup ,and I can do pd and pd and hemo at the same time if needed. I know some people combine the pd and hemo, but my doc said no one do this in my country.

Is there anyone combine pd and hemo here?Any suggestions please?

[Charlie B53]

Not of anyone doing both.  But plenty have done one while waiting for access to develop for the other.  And that has gone both ways.  On PD while waiting for a fistula to develop.  On hemo with a central blood cath while waiting to have a PD cath or a fistula.

MRSA is a very tough little booger.  Follow your Dr's directions precisely.  You have got to kill it completely.

Since it takes time to develop hemo access your Dr may talk to you about a central blood cath to use immediately.   Thus you can have your treatments while waiting for a fistula, and to overcome thatMRSA.  You may have to have your PD cath replaced.  If there are pocket(s) of infection along the outside of the cath, the Dr may recommend removing the cath and cleaning that path to help make SURE to rid you of much of the infection.  Antibibiotics can only do so much.  Removing large sources of infection can greatly speed healing.

Be careful.

Charlie B53

[orion]

But I read a book from kindle , a doctor said in the book that all his pd patient have  fistula as backup. And according a paper I found in the internet, there are 20%pd patients  combine the pd and hemo in japan, (pd five days a week, hemo one time a week)and there conditions are better than people only do pd.
I use vancomycin now , so my infeption is not very bad for now, I think it's save to delay the surgery about 2month , when my fistula get muture.and if I pull out the pd first ,eventually I have undergo three surgery at the end , if do the pitulla first maybe I only need two surgery if I am luck. I hate the tube in the neck too.it's look like uncomfortable, ugly and pain
Am I too naive?

[kickingandscreaming]

I just had my neck access removed after 3 months of usage.  It is not painful and the surgeries (install and remove) are fairly simple.  The problem with this catheter is that it is quite prone to infection and that can be very serious as it goes directly into the heart.  It can also cause stenosis over time.  And you can't take showers with one. Most doctors don't want these to be in for any length of time.  They are for emergency use and for those who can do PD and can't support a fistula or a graft.  For a while my PD catheter was not functioning well and I had to do Hemo a couple of times.  But that's not the same as alternating PD and Hemo. 

[Simon Dog]

And you can't take showers with one.

Sure you can.    Been there, done that.   www.korshield.com.

[Stu]

Yep, I combine the two

I do in centre haemo three times a week x 4 hours, and a PD bag of icodextrin overnight

It works fantastically well for me. I feel pretty good (I think the extra dialysis agrees with me), and my fluid is much better controlled

I get about 800ml off overnight with the icodextrin, which means the fluid restriction is not that nasty (around 2 litres a day). I go into haemo with an average of about 0.5 to 1 kg on

I don't understand why this is not offered to more patients. It's really no more inconvenient that just haemo - I just fill up before I go to bed, and empty out when I get up in the morning.

[kickingandscreaming]

don't understand why this is not offered to more patients. It's really no more inconvenient that just haemo - I just fill up before I go to bed, and empty out when I get up in the morning.

Maybe because it costs more?  It's hard to imagine them (Medicare?) paying for double dialysis.  I am on PD and I am not even being offered an overnight dwell on icodextrin (even though I'm diabetic and a high-average transporter) because it's expensive and will cut into the Dr's and the center's profit margin.  So to hell with my health and long-term peritoneal integrity.  Money uber alles.