Dec 08 2009
Pros and Cons of Peritoneal Dialysis
Peritoneal dialysis is the preferred treatment for many people. You may be a better candidate for peritoneal dialysis than hemodialysis if you have poor hemodialysis access routes or heart instability. You also might prefer peritoneal dialysis instead of hemodialysis because both diet and fluid intake is more liberal, and blood is lost during peritoneal dialysis treatment. Physicians believe that the large fluid gains between hemodialysis treatments place stress on the heart and blood vessels. This is not the case in peritoneal dialysis. In addition, there is a reduced need for some medications, particularly antihypertensives.
There are, however, some disadvantages to peritoneal dialysis. There is a possibility of weight gain (fat) caused by the high amounts of dextrose, or sugar content, of the dialysate. Older people and diabetics require testing of their blood-sugar level as some of the dextrose in the dialysate is absorbed into the bloodstream and can raise the blood sugar to very high levels. Diabetics, however, may add insulin directly to the dialysis solution.
There are some potential catheter-related problems as well. Infections can occur at the catheter site at the external part of the abdomen. In most cases, these infections can easily be treated with antibiotics. The most serious problem that can occur is peritonitis or an infection that develops inside the abdominal cavity. Peritonitis must be treated with antibiotics, although, in the majority of cases, hospitalization is not necessary. When peritonitis is very severe, however, hospitalization is often advised and you may be dialyzed on a machine continuously with antibiotics in the dialysate, and, sometimes, intravenously as well. The risk of peritonitis can be reduced by using the prescribed sterile technique and the close monitoring of your physician.
Which is the best type of peritoneal dialysis?
The type of peritoneal dialysis you choose depends on your medical condition and personal choice. Consult your physician and nurses in the field to help you make an informed decision that will suit your particular needs best.
My husbands been on peritoneal since 2004 and hemo through a central line prior to that. We were told that by going on peritoneal he would live longer and feel better but that the doctors still preferred hemo cause it gave them more control over the patient. I dont think hed be alive today if it wasnt for peritoneal. The years of dialysis are taking their toll but I think the progression of esrd is slower with peritoneal.