Hemo or Peritoneal? Which is better?

[chicky]

My husband had his first dialysis yesterday.  Which is better Hemo or Peritoneal dialysis?  He is not sure which would be best.  His kidney failure is due to diabetes and he has high blood pressure.  His diabetes has been under control for years now.  He's only been on 4 mg of Amaryl.  He has been healthy until 2 months ago when his kindeys started failing.  Please, any suggestions or comments would be greatly appreciated.

[geoffcamp]

I did PD when I first went on dialysis and I hated it.... I had to be hooked to the machine for 11 hours a night and do 1 exchange during the day.  I got pertionitis and that was terrible too.  Then I got a kidney and it lasted three years and when I had to go back on dialysis I choose to try Hemo.  It works out much better for me.  I go three times a week for 3 1/2 hours and I feel better on Hemo then I ever did on PD (not that I feel great but I think Hemo is better).  Just my opinion, I know doctors and others try to tell you how wonder PD is how you have all this freedom and stuff I think it is a line of BS.  They say you can travel well yea by hauling a machine and about 5 boxes of soultion... it's not all they make it up to be.  I hope this helps but I am sure there are people who feel just the oppisite so check out both and listen to what people tell you and try to make the best informed decision you can.

Geoff

[Epoman]

My husband had his first dialysis yesterday.  Which is better Hemo or Peritoneal dialysis?  He is not sure which would be best.  His kidney failure is due to diabetes and he has high blood pressure.  His diabetes has been under control for years now.  He's only been on 4 mg of Amaryl.  He has been healthy until 2 months ago when his kindeys started failing.  Please, any suggestions or comments would be greatly appreciated.

Hello this is the forum to introduce yourself and tell us a little about your situation. Please ask this question in the proper forum "Dialysis: General Discussion". Welcome to the forum and I look forward to your participation. Feel free to reply to this post to tell us about yourself.

[calypso]

Sorry I'm so late to this discussion, but I only just joined this site at the end of March. I've been on PD for about 3 years, I've never done Hemo though so I don't know what that's like, other than what other people tell me they have been through on it.

PD has been very good to me. I've never had peritonitis though, so I've been lucky. Although my PD staff tells me peritonitis is less prevalent now than it used to be. PD is a good modality of treatment if the person doing the treatments on themselves can do it consistently and properly every single time they do it. If they get complacent and slack off and don't follow the procedure properly, or slip up even once and touch something that is supposed to remain sterile to something not sterile, they risk getting peritonitis. It might also help if the patient's immune system is working properly. I don't know why some people get peritonitis and some don't. Maybe it's just a matter of time before I too get it, but I try and take it easy and do it right everytime. I can't say everyone who gets peritonitis got it because they slipped up, or did something to cause it. Anytime you open up the end of the catheter to the outside world you have a direct line into your body for germs to enter. So yes, everytime you hook up, however small the risk, there is that risk of getting an infection in there. You PD staff will tell you how to prevent peritonitis. They too will stress just how important it is to ALWAYS follow the sterile procedure to avoid infection.

I find that on PD your BP tends to remain more stable than most hemo patient's. Because PD is a slower process that goes on continuously, it doesn't have the peaks and valleys of blood pressure and water level or hydration levels that a hemo patient experiences. Your fluid restriction and diet restriction may be a bit less stringent than a hemo patient's. You also get to do it at home rather than having to go to a clinic to have it done although there are home hemo programs available now too. Also you don't have to deal with a fistula and it possible problems. Also no blood is ever transported out of your body. Well except by the blood thirsty vampires also known as Phlebotomists, lol.

I hope I'm not too late in providing info for you to decide on which modality to choose, but if so I wish you the best whatever you decided and hope then that this post may help someone else one day reading this board to decide which to pick.

Of course if you have any questions feel free to ask.

[Rerun]

I was on CAPD 20 years ago and I had to wash my hands for 3 minutes with warm soapy water before each and every exchange.  That was the hardest part for me.  Three minutes is a long time.  Go try it! 

[hyperlite]

When I first started Hemo, the nurses showed me both options (PD and HD). At the time I had a catheter in my shoulder, and couldn't shower. I couldn't stand having that "tube" sticking out of me, and this was the main reason I chose against PD. Also I like to wakeboard and waterski in the summer at my cottage, and they told me that if I was on PD I wouldn't be able to do that anymore. I kind of wish I had the freedom of PD, but without that catheter. But I think if dialysis was only going to be a temporary thing for me, I would go with PD just so I could have that little extra freedom. Anyway thats just my two cents. That's Canadian, so maybe only one cent if we're using American currency 

[Dougndan]

My husband is on Hemo right now but has experienced both. His kidney failure is also due to diabetes and high blood pressure. He started out on PD, everything was going fine until his transplant. After a failed transplant he was back on PD and started having problems, the catheter in his stomach was draining and he kept getting peritonitis. (we think they messed things up during the transplant). Anyway, they decided to remover the catheter, let it heal and redo it. So in the meantime he had to go on Hemo. He discovered he felt better on Hemo,so he decided to stay on it. I think there are pros and cons to both. I think it just has to be a personal decision, and hopefully what ever you chose will work for your husband!  I know one concern with PD and diabetes is blood sugar levels rising because of the solution has glucose in it. My husband did not have a problem with that. Good Luck!

[angieskidney]

http://kidney.niddk.nih.gov/kudiseases/pubs/choosingtreatment/
it covers these (taken right from the page):
Kidney Failure: Choosing a Treatment That's Right for You
On this page:

Introduction
When Your Kidneys Fail
Treatment Choice: Hemodialysis
Treatment Choice: Peritoneal Dialysis
Treatment Choice: Kidney Transplantation
Treatment Choice: Refusing or Withdrawing From Treatment
Paying for Treatment
Conclusion
Resources
Acknowledgments



I have been on both types of dialysis. PD back in 1990 when you had to worry more about a steril environment and then in 2001 to 2005 and then I got the worse case of Peritonitis they had seen in 20 years and said it was NOT caused by anything I did but they couldn't tell me what .. so I had to go on Hemo.

There are pros and cons to both and you can't really say one is best for everyone because everyone has different opinions.

I was trying to find my post from another board .. but go figure .. it is MSN Groups and they do not support any feature for finding your past posts .. so it is lost forever ... it was a comparison of Hemo and PD ... just do a search on the net for just that. I don't feel like typing it all over agian here since I am a bad speller (dyslexic).

But I will say I liked the freedom of CCPD (Cycler in Canada) but didn't like CAPD cuz that was done 4 times every day ...  I am doing HD now but must go into the clinic to do it ... I would suggest trying to get into at home nocturnal Hemo .. but that takes a little training and depending on the type of machine .. maybe some alteration to plumbing. Anyway, I found it VERY easy to travel with the Cycler (CCPD) but with Hemo .. I can't travel to the States ... only within Canada .. which really REALLY limits me unlike PD did (I went to MN while on PD with NO hassle and NO problems what so ever)!

With Hemo there is more of a diet restriction and fluid restriction.

[Panda_9]

Its really your choice as to what you think you would prefer. It is different for everyone. Personally I preferred PD for a few reasons, however it wasn't adequate for me, so I had no choice but to do hemo. In general PD gives you more freedom with fluid and diet restrictions, as you are pretty much constantly dialysing. With hemo, there is the rollercoaster effect, which can leave you feeling like crap alot of the time, because treatments are generally 3 times a week. You also normally have 2 days off in a row over the weekend, which is probably the toughest time. You have to be extra careful with fluids and diet on those days.

I think PD is more gentle on your body, and if it works for you, then I think its the way to go. It is a pain to have a tube in you all the time, but its also a pain to have to stick 2 needles in your arm 3+ times a week. You can go on longer holidays on PD, and you don't have to worry about booking into another dialysis clinic like you do with hemo. I'm not sure about other countries, but here if we want to go away, we can have all the PD bags delivered to our holiday address, ready for when we get there.

I know there are others on this forum who prefer hemo, so its really a personal preference. I prefer hemo because I feel alot better, but that is only because PD did not give me sufficient dialysis, and I am lucky enough to be doing nocturnal dialysis. Some people feel better on PD, and some feel better on hemo.