Peritoneal Dialysis a Convenient Choice

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Peritoneal Dialysis a Convenient Choice

By Gen Lucidi Payne
Last updated: January 07, 2011

“Overwhelming” is how James Gralewski and his wife, Gloria, describe their rush of emotions when James was told he must go on dialysis. Like most soon-to-be dialysis patients and their caregivers, the North Huntingdon couple were consumed with concerns how would dialysis change their lives and what type of dialysis best fit their lifestyle?

“At first I was in denial because it was hard to accept and understand what was happening. Sure, I felt tired, but I didn’t think it was a major problem,” the 58- year-old retired General Motors employee recalls.

Now eight months later, James is breathing a sigh of relief, calling dialysis a routine that has become just another part of his life. “I feel better and am not as tired as I was before. It’s even easier for me to keep up with our five grandchildren. Dialysis fits fine into our lifestyle.”

He credits his doctor, James Weiss, with easing the transition to dialysis by walking him through the steps ahead and explaining his dialysis home or clinic treatment options.

James decided on peritoneal dialysis (PD) because the exchanges take place during the night while he sleeps in his own bed. Even though Gloria was concerned the home treatments would be too difficult, she agreed to keep an open mind until she learned more about procedures and equipment.

After a two-week training, the couple were convinced PD was the right choice. Michele Gaynord of the Monroeville DaVita Center set up the portable cycler machine and taught them how to operate the equipment. James’ doctor performed the preparatory medical procedures that included inserting a permanent catheter in his abdominal wall to enable the dialysis exchanges.

The catheter connects to the cycler that automatically controls the timing of exchanges, drains the used solution and fills the peritoneal cavity with new solution — all while James sleeps.

“It took some time to get used to, but now it’s great,” says Gloria, also a General Motors retiree.

Gloria has learned each dialysis step and urges other spouses or caregivers to do the same. “Another set of eyes is helpful so if there is a problem they can help. Also, it gives patients the support and confidence of knowing they are not in it alone.”

As a DaVita patient, James is routinely examined and has blood tests at the Monroeville clinic. Staff is on call to help as needed. His supplies for the dialysis exchanges and equipment are automatically delivered by Baxter Healthcare Corp.

Occasionally, the Gralewskis take short trips for a day or two. On those away-from-home overnights, James takes along full bags of dialysis solution with plastic tubing that attaches to the catheter and does the exchanges manually during the day.

James’ progression to dialysis is similar to many other patients. He was diagnosed with diabetes in his mid-30s. Eight years ago he learned his kidneys were failing. Once his kidney function decreased, he needed dialysis.

The Gralewskis urge other couples facing dialysis not to fear it as the unknown. “Understanding dialysis eliminates the mystery, eases apprehensions and makes everyone involved more comfortable.”

DIALYSIS OPTIONS:

Several forms of dialysis, the process of artificially cleaning toxins from the blood, are available when the kidneys are no longer properly functioning.

HEMODIALYSIS

Hemodialysis, performed at hospitals and dialysis centers, is probably the best known dialysis procedure. Patients are hooked up, via a tube in the veins, to a machine that circulates the blood through semi-permeable filters that take out the toxins in the blood. The procedure usually takes three to four hours, three days a week.

Patients can also have hemodialysis treatments in the home. In this procedure, patients’ blood flows from their vascular access through a compact dialysis machine to be cleansed of extra waste and fluids and returned to the body.

Travel is possible by pre-arranging for treatments at clinics in visiting locations. Also, some centers offer nocturnal hemodialysis that enables patients to go to a clinic three nights a week at approximately 8 p.m. and dialyzes overnight while sleeping at the clinic.

PERITONEAL DIALYSIS (PD)

PD gives patients the flexibility of having treatments at home, work or on trips. In PD, a catheter, filled with a cleansing solution that filters waste products and excess fluids, is inserted through the abdominal wall and into the peritoneal cavity. A portion of the catheter remains outside the abdomen and under clothing to drain the used solution for disposal and to accommodate fresh bags of solution for the next exchange.

THE TWO TYPES OF PD

Continuous ambulatory does not require a machine and can be done any place that is clean and well lit. All that is needed is a full bag of dialysis solution and the plastic tubing that comes attached to the bag. Patients can walk around and do their normal activities while the exchange takes place. Thirty minute treatments are usually four times daily, seven days a week.

Automated peritoneal dialysis is done with a catheter connected to a portable cycler machine that automatically controls the timing of exchanges, drains the used solution and fills the peritoneal cavity with new solution. It is usually done each night while the patient sleeps.


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