Does dialysis help preserve residual kidney function or deteriorate it?

[gilders]

I am hopeful of obtaining a living donor for transplant, but the process is so slow in my area that it is likely I will need dialysis first.
I have read that HD will make my current kidney function deteriorate, but can not find info on whether PD will preserve, deteriorate, or have no effect on current function.

[cassandra]

As far as I know your kidney function will deteriorate less fast with PD. I still produced some urine after 5 years PD.

Luck and love, Cas

[Michael Murphy]

Residuak Kidney Function (RKF) is important and research is being conducted on how to preserve it.  I have been on dialysis for 42 months now and I still eliminate what I drink.  I avoid anything that will damage my remaining function.  I have had doctors tell me I am on dialysis anyway, the look on their faces when I start on the moronic statement that they just made is a sight to behold.  Today I drink what I want, following their stupid logic I would end up fluid restricted,

[iolaire]

I've been told PD does a better job retaining kidney function.

Like @Michael Murphy I'm 30 months in and still have my full urine output.  I expect that relates to the type of kidney damage (for me scarring from active lupus in the 1990's) and how much damage is done to the kidney pre-dialysis.  I would assume those of us who have had slow gradual kidney decline and ease into dialysis long before we really have complete kidney failure end up with more time urinating (and more time on dialysis)...

[kristina]

I am hopeful of obtaining a living donor for transplant, but the process is so slow in my area that it is likely I will need dialysis first.
I have read that HD will make my current kidney function deteriorate, but can not find info on whether PD will preserve, deteriorate, or have no effect on current function.

Hello gilders,
I was pre-dialysis for over 43 years due to chronic proliferative glomerulonephritis with Lupus SLE-involvement and I tried ever so hard to keep my little kidney function going for as long as possible
but eventually I had to start with my dialysis-treatment in December 2014 and I still continue to "pamper" my remaining kidney function with my kidney-friendly-vegetarian diet, regular walks etc. as best as possible and fortunately my kidneys have responded and are still "producing". I don't think that my dialysis-treatment had any negative effect on my kidney function and I have also noticed that "the rest of my body" has welcomed the wonderful break dialysis has provided my body with, after struggling for so many years whilst being pre-dialysis.
I have also noticed that a strong determination and a strong discipline in terms of kidney-friendly-vegetarian-diet and liquid restrictions assists me a lot to preserve my kidney-function for as long as possible and the more disciplined I have become in terms of kidney-friendly-diet, liquid restrictions and keeping as fit as I possibly can, the better my chances have become to feel a little better ...
Good luck wishes from Kristina.

[Michael Murphy]

I think the problem is that there is a tendency among the Health Care people(doctors, nurses, and tech) to aggressively push fluid restrictions and fluid removal.  Personally I just was ambushed by my doctor about fluid retention.  After 3.5 years of Hemo with no fluid restrictions he has decided that since fluid retention would kill me it's time to put me on fluid restrictions.  I asked for the symptom that suggested this, he said none.  I said no.  I feel that dehydration is currently the biggest danger my Resiual Kidney Function faces.  As long as don't see any swelling or shortness of breath.  I think I will continue to drink what I want and let my to best friends my kidneys keep on eliminating,

[Charlie B53]

Just a bit over three years on PD.  I still produce maybe a liter a day depending on how much I drink.  And I do NOT restrict my fluid intake much.  I drink mostly ice water, day and night.  I do not drink soda's.  I will once in a while have a bit of milk or maybe even fruit juice if I am very thirsty AND my blood sugar is low.  Otherwise I try to avoid those quick acting sugars.    I've only become diabetic since starting Dialysis so I am still learning to avoid the simple sugars and excessive starches.   I still have a lot to learn.


Fluids are no longer a problem as PD is working very well for me so far.

[Fabkiwi06]

My neph suggested I pick PD because of my remaining kidney function. I estimate I eliminate about half to two/thirds of what I take in. I started with a (largish) fluid restriction, but I've all but done away with that given the summer months. My function is still extremely low, but it is stable. In comparison, when I was briefly on hemo, I hardly ever peed. So, I'd say the PD has helped me maintain.

[gilders]

Thank you all for your advice.
I had an appointment with a PD nurse yesterday and explained that I was hesitant about starting PD because I had read that transplants aren't as successful performed after dialysis has begun.
She said that the best transplant patients are those that are the healthiest and I would be healthier on PD rather than postponing it. This seemed to make sense and seemed like starting PD would be the best choice.
But when I returned home I rechecked what I had previously read and found quite a few medical reports that do show transplants performed after dialysis has started are roughly 3x more likely to suffer rejection.
So it seems like early PD will help me "survive" the actual transplant operation, but will make the new kidney 3x more likely to be rejected.

I feel like I'm being forced into dialysis and I really don't know if it's the best option for me. Having have periods of up to 8 years where my kidney function stabilises and currently being at 16%, I don't want to start PD too early as the peritoneal lining doesn't last for ever.

I feel like HD dialysis is the beginning of the end for me, PD will postpone HD and transplant will postpone PD.

[Fabkiwi06]

There are gonna be a lot of factors involved. Your age, health, current function, rate of decline, how you feel now, how sick you're willing to get, and how fast you can get a transplant all are gonna have to be considered. If you have a live donor, get going on that ASAP - mine has taken about 5 months to get all the testing and approvals sorted (and i'm still waiting to get the final approvals and surgery scheduled. total time estimate i was given was about a year to get it set up). If you're stuck waiting on the list, you're gonna be waiting a few years and will probably end up starting dialysis first.

Ideally, yes... you want to skip and go straight to the transplant. Realistically, that doesn't always work out.


Edit to add: I was at a stable kidney function of 15% for many years too. But, when it went south, it went FAST - in a matter of days.