I am getting to the point where I have to start dialysis and I want to do PD. I am on the transplant list and do not want to deal with a fistula after I receive a new kidney (I am being very optimistic). Has anyone ever done PD with a gastric pacemaker? Better yet, can a person do PD with a gastric pacemaker? I know there would be a risk of infection, but isn't there always a risk for most anything that has to do with dialysis. My surgeon says he doesn't think PD is a good idea and my nephrologist says it's ultimately her decision but I think it's my decio! I would appreciate anyone's input on this subject. Thanks in advance.
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If you have polycystic kidney disease, then PD is a very poor choice for you. Also, since ALL forms of PD come with an elevated risk of infection, you will probably at some point get an infection of the peritoneum, at which point you will HAVE to do hemodialysis, at least until the infection clears up (if it didn't cause irreparable damage, that is), and at that point, if you don't have a fistula, you will be fitted with a "neck catheter". Trust me, you don't want that.... -
I echo dac0214's position. PKD patients are challenged for the abdominal spare required for PD - the fluids you must carry, owed to kidneys enlarged from the presence of cysts. I'm certain there are PD patients that have avoided PD port related infections or at least those requiring temporary hemodialysis and not damaging the peritoneum in the process, the "foreign body" port in the abdomen is simply more susceptible to infection than the AVF.
The "neck catheter" is also known as a central venous catheter, which is surgically inserted in the neck and threaded/screwed into one of the major arteries of the heart. These catheters are also prone to infection and meant as a temporary means to achieve hemodialysis. They are also prone to clotting and deliver the poorest quality hemodialysis because the in and out blood flows originate from virtually the same spot, causing a great deal of blood recirculation and thus poor clearance. Additionally, they are far more subject to blood flow performance issues with patient movement of the head.Comment
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Great question! Certainly this is a question that your Nephrologist would need to address but PD is typically not recommended for patients with a gastric pacemaker because of concerns related to the GI symptoms and potential for those symptoms to increase due to the impact PD can have on gastric emptying. PD is a wonderful modality option for most and the infection rates in PD have improved and are better than dialysis patients who have a Central Venous Catheter. Access and modality choice are ultimately decided upon with your Nephrologist and are highly individualized for each patient. Those patients who experience infections in PD do not always transfer into hemodialysis and are typically treated and remain on PD therapy. Knowledge is power so continue to research your options and dialogue with your dialysis care team.Comment
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How do you prevent the PD infectionsComment
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With extremely careful following of cleanliness protocols, and a lotta luck.....Originally posted by MissATW View PostComment
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