There are a number of dialysis choices available to patients at the UVM Medical Center. Varun Agrawal, MD, blogged about home dialysis earlier this month. In addition to peritoneal dialysis, home hemodialysis, and in-center hemodialysis, other choices for treatment of kidney failure include kidney transplant and medical management of symptoms. All of these choices are treatments for your kidney disease, not a cure. Over the rest of your life you may use more than one treatment choice depending on changes in your lifestyle or health needs.
A transplant is an operation, performed by a transplant surgeon, where a healthy kidney from a donor (another person living or deceased) is placed in your body, replacing your non-working kidneys. This is the closest you can get to your own “native” kidney.
Prior to receiving a kidney, a lot of tests will be performed to check on your heart, lungs, and other body functions. Your transplant team will work with you to assess your general health and how hard you work at staying healthy. Once you have been accepted and registered on the United Network for Organ Sharing (UNOS), you will begin the wait for your kidney. The wait time depends on the number of available kidneys and if they are a “suitable” match. During this wait time you may need to start dialysis. Your transplant team will follow you closely.
Medical Management of Symptoms
Another choice is medical management of symptoms related to kidney failure. You will be closely followed by your nephrologist (kidney doctor) and primary medical doctor to treat symptoms including swelling, high blood pressure, decreased appetite, and nausea to name a few.
This option is sometimes more difficult to talk about because it may or may not lead more quickly to death. However, it is important to note that people can still enjoy a quality of life that will allow them to do many of the things that bring them enjoyment.
How Do I Choose?
So now you know a little bit about your treatment choices, how do you choose? Get all the information you need to make a comfortable, informed decision. Discuss your treatment options with your family/significant other, your doctor, and your treatment team. There are many online resources that can help you decide, but here are some things you can think about.
- How will my choice affect my lifestyle? Can I change my choice or am I stuck with it? Can I travel, work, exercise, drive?
- Can I talk to another dialysis patient?
- When do I need to start dialysis?
- How is dialysis paid for? Will I need new medications and how are they paid for?
- Will my diet have to change? Can I drink whatever I want to?
- Will I have to go to a dialysis center and how often? How far away is the center? Do I get to choose my schedule? How will I get there? How long a day will I have? How will I feel after dialysis?
- Do I have to have someone trained to help me at home or can I do dialysis on my own? How do I get supplies at home and how do I store them? How much storage space do I need? Am I strong enough physically and emotionally to care for myself?
- When should I have my access placed? Who arranges it? Will it hurt?
- Am I a transplant candidate? How do I get on the list?
- Who can I talk to for more information about my choices for treatment of my kidney failure?
Finding out your kidneys are failing, doesn’t have to be a death sentence. You can go on to live a normal life, with a few adjustments, depending on the treatment choices you make.
Here, in the Home Dialysis Program, we are dedicated to helping you find a treatment choice that is flexible, fits your needs and provides safe and adequate dialysis, preferably in the comfort of your own home!
Please join us at an open house to celebrate the new Home Dialysis Program clinic space on March 25, 2016 from 2:00 p.m. – 4:00 p.m. at 35 Joy Drive in South Burlington, Vermont.
Resources for Patients
American Association of Kidney Patients
- Phone Number: 1-800-749-2257
National Kidney Foundation
- Phone Number: 1-855-653-2273
Centers for Medicare & Medicaid Servics (CMS)
Home Dialysis Central
- Phone Number: 1-608-833-8033
Melanie Porter is an RN III in Renal Services at the University of Vermont Medical Center.