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PD or Hemo: Pros/cons of each treatment from patient

If you're getting ready or know someone who has dialysis on the horizon, please read on. I've been dealing with kidney disease for 24 years and have been on both peritoneal and hemo dialysis. I'd be remiss not to share this info as I wasn't given much info when I had to choose.
So here goes:

Peritoneal Dialysis (PD)
Pros:
*Home treatment. You do it in the privacy of your own home to yourself. You are your own nurse. You decide when.
*You do it everyday so your diet isn't as strict and blood work is more stable.
*There's no big needles. Less invasive. Less pain. You work with a catheter permanently sticking out of your abdomen.
*If you choose the overnight cycler, nightly you hook up, dialyze while you sleep, wake up, unhook and you're done. Some people prefer this and have little problems..

Cons:
*Does not clean the blood out as good as hemo. It became quite ineffective for me having to make a lot of adjustments that complicated things and still did't work very well
*Machine is not for everyone. i didn't like it so went back to manual PD, where I was dedicating up to 30 hrs/wk doing it several times during the day.
*Machine can create a lot of discomfort when it drains you. They program it so it's difficult to stop the drain as it's trying to pump it out of you can really hurt. Plus it doesn't take much to make the alarms go off.
*Threat of infection is high. You have to sterilize your hands, wear a mask, be a germaphobe when you do your treatment. Remember this is a catheter with access to your internal abdomen. Have to take a lot of steps to protect it.
*You get A LOT of boxes of medical supplies delivered to your home every month. With the cycler, 30-40 boxes. Have to have room for it all.
*It creates a lot of medical waste you have to dispose of. The cycler creates twice as much medical waste than manual PD.
You are responsible for doing it right so your monthly labs look good. If you don't, you get a bunch of fingers wagging at you, treating you like a two year old being lectured. They don't talk with you, they talk at you.
*Discomfort: You're putting in a lot of fluid in your abdomen that is in at all times.
*Swimming/bath restrictions
*Not as popular of a treatment so not that many nurses and most of them rookies.

Hemodialysis (HD):
Pros:
*Don't have to do it everyday. Freedom.
*Nurse in clinic does it for you. You are free from lab results responsibility
*No home waste or supplies. All at a clinic where it belongs
*More experienced nurses, more clinics. (Some hemo clinics don't have a PD dept. at all)
*No worrying about infection
*Swimming/bath freedom
*More effective in cleaning the blood (A common myth is your blood is replaced. It's not. It's filtered)

Cons:
*You don't choose when to do it during the day, you have set times to go to the clinic three times a week
*Invasive. A shunt is placed under the skin in the arms as an entry for the needles you get stuck with three times a week
*Since not doing it everyday, diet is more strict and blood work can be less stable
*Pretty wiped out after the treatment. It can pull five pounds of fluid out of you in three hours. Blood pressure gets really low and it doesn't feel very good. Have to adhere to strict diet if you want to avoid that much of a crash

If you have any questions I can answer, or want to add to the list, feel free to reply or send email through this site. Serious questions regarding your particular situation should be discussed with a Dr.
Briefly my experience: I tried PD for two years and now going back to hemo. I couldn't handle the amount of fluid my Dr prescribed, even when he lowered the amount, it was too uncomfortable for my very small frame. So I wasn't getting enough dialysis.This treatment isn't for everyone. Also my PD nurse, the only one in the county with this company, wasn't working for me very well. A nervous rookie that only made me uncomfortable and nervous. My hemo experience started 22 years ago, the time in between I had a transplant.
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replied October 17th, 2012
Dialysis or Not
hello there! good day!
my dad has a weak kidney function due to a kidney aorta aneurysm and is ready for dialysis. now his kidney function is 16% as the doctor said. presently he is suffering from edema in the legs and feet and also stomach pain.going to emergency hospital for a couple of times does not help they check and pain reliever is given, thtas it. his creatinine is 283 and urea is high as well.
im worried of his feet and pain.he is also diabetic. in your opinion as an experienced person in kidney desease,
is it time to have dialysis even if his kidney function is still 16%? will his edema and lower back pain will get worse or it will subside later(without dialysis)?
if he will Undergo dialysis treatment will it prevent the swelling and pains he has now?
i am just very worried that if he cannot decide to have the dialysis treatment, complication will occur and worse things will happen to him.

thanks in advance! God bless...
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replied October 17th, 2012
Hi there,

I'm so sorry to hear about your dad. It's a hard thing to go through, my deepest sympathies.
If he has edema and his creatinine is high (I never heard of it being that high, 7.2 is high) He is dying my friend. Dialysis shouldn't be a "choice", it's the only option he has, his doctors should have him on hemodialysis now. All doctors know edema is a symptom of end-stage and needs immediate treatment. His electrolytes (potassium and phosphorus) are probably climbing and that can lead to heart attack. No waiting around for things to get worse. This is serious. He needs fast-acting hemodialysis now.
Yes, the dialysis will relieve the swelling in feet and pain in his back. 16% kidney function isn't enough to stabilize your dad anymore and it's showing.
There can be complications with dialysis, yes. But without it your dad will die. It is a tough decision, I know. I feel for you. But I really think the best thing you can do for him is to get him on hemodialysis right away. He will feel better eventually, after all the initial set-up =)
Good luck and god bless~!
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