Transitioning to PD from In-center Hemo?

[Rbeckett]

Any one recently transition to PD from in-center? i am looking at changing my treatment to PD for the additional freedom it will hopefully give me. ANy stories, good or bad? Would you do it again? Need some info on quality of life, maintaining your shemistry and over all observations of the change. Thanks in advance for you thoughts and opinions.
Wheelchair Bob

[daalger]

Bob,

My husband was on PD and had to have his catheter removed and he is doing hemo with a permacath until he has a transplant. (Hopefully. That's another long story)
If his living donor can't donate, he is planning to go back on PD. He felt it gave him more freedom during the day.
~~ Debbie

[Rbeckett]

Debbie,
Thanks for the reply!!! Did his PD reallky give him more freedom? Going to a distant clinic (1 hr drive each way) is getting too expensive and the clinic I go to is getting too busy and too noisey. So I figure it is time to make a change if it will have a positive or neutral impact on my over all conditions. I have a bunch of co-morbid issues all stacked together so I have to walk a pretty fine line with meds and activities. Less restrictive diet and daily freedom will be a much welcomed thing. Three years at the clinic is long enough, especialy since I am capable of caring for myself to a much larger degree now that I have recovered from the initial shock and newness of disability. Thanks for the help and motivation.
Bob

[daalger]

Bob,
Yes, Allen (my husband) said that he liked having his days free. He did the cycler at night. Allen was hooked up for about 9 hours so he went to bed earlier than he would have liked, but then his days were open. Allen doesn't like going to the center 3 days a week and scheduling other things around it.
We also traveled a lot to visit our families out of state and took the cycler and supplies with us. Allen could do his PD wherever we went without pre-planning if we drove. He hasn't been able to travel since going on Hemo. Like you, Allen is still independent. I went to visit my kids once without him and I felt guilty about it.
I will tell you that P-D caths are extremely susceptible to infection, so you have to be meticulous in caring for it.
Good luck with your decision.
Debbie

[kkri]

This is exactly the issue that concerns me. I started hemodialysis a year ago using a permacath while my first fistula failed to mature. The catheter became infected and needed to be re-done while a second fistula developed. The second fistula is working fine and I tolerate it well. But I remember the nurses and techs being anxious for me to move off the catheter because it was less effective and prone to infection. Is it a step backwards to consider PD and another catheter?

[daalger]

I wouldn't say the PD cath is a step backwards. It is a different option. If you have the room at home and someone to help and can use careful sterile technique during hookup, it's something you can discuss with your physician.

[portia9898]

Hi,

I went on CAPD 25 years ago. I love it so much I chose not to go back on the transplant list after graduating from college, as I originally planned. I have travelled to as far away as Hawaii. I have eaten almost everything I couldn't on hemo I can drink as much as I want, though I'm small 4'8" & about 84lbs, some bigger patient have fluid restrictions but they are usually better than those on Hemo. I feel much better than when I did on Hemo or with my good transplant, so I have more energy & can get many more everyday things done. Plus, I only go to the clinic 1 or 2 times a month. But there are some negatives. I have had peritonitis about 9 or 10 times over the years. I won't lie it hurts but it is easily treatable with antibiotics. If you eat too much sugary things it's more difficult to pull off fluid. I learned that one New Year's Eve I also had to have my access cath replaced after 20 years and that wasn't fun. Finally, the one of the things I like best about CAPD is I have the control over my treatment, but it does come with more responsibility. Hope this helps you make your decision.

[chemwiz1]

I started CAPD in 2006 after my kidneys failed due to polycystic kidney disease (PKD) and was on it for almost a year when I got my transplant. The transplant started failing after only 4 months due to BK virus (no cure) and completely failed by the end of 2008, at which time I went back on CAPD. I switched to CCPD (continuous cycler PD) in January 2009 and did so well on it for years that I moved my name from the active to the inactive transplant list because I didn't want one. I felt a million times better on PD than I ever did with the transplant, even during the 4 months when it was working. Don't let anyone fool you -- the immunosuppressive drugs are hell and led to numerous long-term side effects that I'm still dealing with (gum destruction, osteoporosis, high cholesterol), not to mention the acute side effects such as steroid-induced diabetes, super high blood pressure (I had to be on 3 bp medications while the transplant was "working"), severe gum sores, digestive problems and uncontrolled diarrhea, hair loss and skin problems).

I am currently on hemodialysis (hemo) 3 d/wk at a clinic because gram negative and anaerobic bacteria migrated from my intestines into my peritoneum in early July 2012, causing peritonitis. We tried treating it outpatient at my PD dialysis center, but every time we thought we had it licked, it came roaring back. I ended up in the hospital in mid-August 2012 with abdominal pain so bad that it doubled me over. My PD catheter had to be removed because it was thought that the bacteria had formed a biofilm on it, which no antibiotic can kill. That meant I had to go immediately to hemo with a chest catheter. It took several weeks for my intestines to get back to mostly normal. The doctors think the bacteria came from a diverticulitis attack that formed one or more microperforations in my intestine or colon. I was diagnosed with diverticulosis years ago -- it goes along with PKD -- but I'd never experienced anything like what led to this peritonitis. I had never had peritonitis from a contamination (e.g., touching or breathing on the PD catheter end or something else related to my dialysis) or from a contamination of my PD catheter.

Now having experienced all 3 modes of kidney replacement therapy, I can say, hands-down, that PD is the BEST. My doctor says I can get a new PD catheter after Thanksgiving and that I should be up and running on the PD by the first of the year. I cannot wait. I don't know how so many in-center hemo patients put up with the blood access, having to sit still for so many hours, the clotting and drops in blood pressure, the dietary and fluid restrictions, chances of infection or failure in chest catheters or fistulas, permanent disfigurement from blown fistulas -- the list goes on and on. ALL of these things go away with PD, and I had so much more energy and felt so GOOD while on PD. I feel ill all the time on hemo and just can't deal with it anymore.

Switch to PD. You'll wonder why you didn't do it sooner!