Planning Ahead For Dialysis Choice Before You Need It Can Lead To Better Outcomes

If you have been told by your kidney doctor that it is likely you will progress to ESRD, you have some decisions to make-is a transplant right for you, and if you need dialysis, what type- Peritoneal Dialysis or Hemodialysis? One thing we know you do not want is for a decision to be made abruptly for you in the hospital, should you require unplanned dialysis, where you require a CVC (Central Venous Catheter), which are highly susceptible to infections which can lead to life threatening if used longterm. In acute cases, where no access exists, a CVC will be temporarily required until another permanent access can be placed and is usable. It is possible to acutely have a Peritoneal Dialysis Catheter placed. You can receive dialysis with this type of catheter in the hospital and then receive training from specialized PD nurses to learn to perform this dialysis yourself (no blood or needles) in an outpatient setting. A machine (cycler) can also be used to do this type of dialysis when you sleep, leaving your days free. This is often of interest to patients who want to work, something we encourage when possible. Discuss your potential choices with your nephrologist well in advance, so if a decision ever has to be made unexpectedly (acutely), you understand the options and terms discussed. It maybe useful to visit a dialysis center well, as directed by your doctor, to see what is involved with both types of dialysis and meet the team members. A peritoneal dialysis catheter can be placed (tunneled) and left unused...sometimes for years...until you may need it. A hemodialysis access (fistula) needs 8 weeks after surgery to mature. If you are on dialysis now and have a CVC, no doubt your dialysis team is on you to get a permanent access placed. LISTEN. You're well being is always our primary concern