Is CPD a good idea?

[hookedonheparin]

I have been on dialisys for a while and my fistula is hurting a lot, I am trying to convince my doctor to do CPD, and he is not very happy about my choice, however he is not the one having to deal with the pain every day, I do home dialisys 5 to 6 times per week, and the pain on my fistula seems to get worse every day, any coments or advise please.




Edited: Fixed error in subject line - okarol/admin

[Wallyz]

PD will give you much worse dialysis. What type of pain is it?  Just when you stick, or is it continuous?

[Ken Shelmerdine]

PD will give you much worse dialysis. What type of pain is it?  Just when you stick, or is it continuous?

Wrong. As far as  I understand it PD gives as good a dialysis as haemo given that the patient has a functioning peritoneal membrane and a correctly positioned catheter. It also has the advantage in that the dialysis takes place while you sleep and therefore does not take up valuable leisure time.

[peleroja]

I agree with Ken.  PD is done nearly 24/7, as close to real kidneys as you can get.  Even when I was doing 6 exchanges a day, I never found it as intrusive as the 3 months when I was on hemo.

[Wallyz]

Those are  a couple big ifs, and while people on PD like it better, the mortality rates are much higher. Daily or near daily home hemo is the best kind of dialysis offered.  Ideally, it is done overnights, like PD.  HoH, you might want to look at extended nights, and use benadryl, like Neo, another member here on IHD.

[peleroja]

Wallyz, I've never heard that mortality rates on PD are much higher.  Please cite your sources. 

[Zach]

PD is done nearly 24/7, as close to real kidneys as you can get. 

Unfortunately, that is not true.
 

[jbeany]

http://jasn.asnjournals.org/cgi/reprint/14/11/2851.pdf

Wallyz, I've never heard that mortality rates on PD are much higher.  Please cite your sources. 

Long term, PD mortality rates are higher.

[Wallyz]

Wallyz, I've never heard that mortality rates on PD are much higher.  Please cite your sources. 

Please click on the link in original post.

[TheSpleen]

PD will give you much worse dialysis.

Don't give people shitty advice.
Most things in life are not black and white, so when someone makes a statement as cut and dried as this, odds are pretty good it's inacurate, or at least incomplete.

For instance http://cat.inist.fr/?aModele=afficheN&cpsidt=2053782  :
...we present evidence that CAPD/CCPD, a newer and less costly method of renal replacement therapy, is not associated with increased mortality rates relative to hemodialysis.

http://www.nature.com/ki/journal/v57/n4/abs/4491513a.html  :
There was no survival advantage for either modality in any of the major subgroups defined by age, sex, or diabetic status.

There surely are other studies that will suggest the opposite is true. Bottom line is it's not as simple as "one is much worse than the other." There are probably lots of other factors that would determine which is best for you.

[G-Ma]

    welcome hooked...I have heard and experienced good about home hemo and am back on incenter and know several people on PD who are very happy with it.  What is your Dr's reason for not being happy about your choice?  Have you had major stomach surgeries that would prevent it from working?  That is my problem.  Opened from chest to Navel so they don't think I have a good chance of PD to work otherwise I would have wanted to try it.  Talk to your Dr..there must be reasons???  Also look for reasons for the pain in your fistula..is it every site? are you doing laddering to strengthen the whole fistula? if not try using a different site...mine just has a lot of pain when it needs a fistulagram.  Check with a surgeon who specializing in your veins.
Ann