From PD to HD

[Johnylefox]

Hello.
I started home PD in February and it was 2 yellow bags per night whilst I was peeing maybe one litre per day.
Now I am on 2 yellow bags, 1 green bag and 1 purple bag for a daytime dwell. I now dialyse round the clock and pee about 500mls per day max.
My creatinine was up to 1600 a few weeks ago at the time of a bout of pneumonia.
Now it is 1100.
My Neph thinks dialysis is not working so he suggested HD.
I need to have a fistula inserted next week.
Has anyone ever gone from home PD to HD? If so what where the pro's and con's.
At present I struggle with the diet, drainage cramps, fatigue and the emotional side of things.
Will HD offer any benefits?

[wagolynn]

Hi Johnylefox,

If PD is not working there is little choice but to go onto HD, it will work, and probably offers more control.

Diet is something you need to get to grips with, Dialysis does not remove Phosphate or Potassium (the two Ps) very well. The diet aims to reduce the intake down to a safe level, your kidneys did this when the were healthy.

Most food we normally eat has the two Ps in it, we cannot eliminate them (they are very important to life), therefore we must balance what we eat, choosing foods with low two Ps, and only having small amounts of foods where the Ps are high.

Your dietician will make suggestions based on your normal diet, these he/she will modify in response to your monthly blood results. The closer you can work with the dietician the sooner you get things under control. There are books giving some recipes, these can be used to give you some ideas.

There are websites that show the amounts of the two Ps in foodstuffs, and once you get the hang of it, you will find it is very flexible rather than having very rigid rules.

[rheaybou]

Hi Johnny.

I went from PD to HD and the only issue I found was the times offered for dialysis slots. As you pointed out, I started on two bags of yellow overnight with an extraneal day fill. My creatinine near to the end of my year pushing PD was 2200 and my BP and fluid overload was 220/165 and about 6kg.

You get sold on PD for diet flexibility, however it's not always the case.

HD made me feel 100% better, however the days between sessions you feel worse and a 4hr dialysis session does wipe you out at the start. Long term I would have pushed for home HD and looking into overnight HD as its more gentle.

[Johnylefox]

Thanks all.
Was it possible to do some part time work whilst on HD?

[rheaybou]

Hi.

I am an engineer and office based so I was able to work a ful 38hr week with a Tuesday and Thursday morning spent at dialysis working while having treatment. Would then head to work for the afternoon.

Was tough and after my Saturday session I would sleep the rest of the day. But it was what I needed, feeling normal by getting on with life was my way of dealing with what was happening rather than talk about it.

Your employer has to make reasonable adjustments to your environment and role under law, I was very fortunate to be able to do what I did and I have read stories that are not as positive as mine. Do what you need to do work wise for both the money and mental side.

[JMan]

You should have a read about fistulas here, especially their immediate aftercare after the op is done:

http://esrdncc.org/ffcl/for-ffcl-patien ... materials/

http://www.nhs.uk/Conditions/Dialysis/P ... ormed.aspx

Fistula Fanatic:
Facebook page for better fistula care:

https://www.facebook.com/purplechick820?fref=nf


Kidneypatientguide has its own info on heamodialysis which is worth a look.

You can also compare dialysis types here http://www.davita.com/treatmentevaluator/ which might give you some insight into how the different treatments work for different lifestyles and situations

My home dialysis setup can be viewed here https://www.facebook.com/media/set/?set ... 02a3b3a45b

Many, but not all manage to keep a fairly normal life, and work with nocturnal or short daily dialysis (which gives often gives better treatment than 3 times a week in the unit. Some units are now offering 'in house' nocturnal dialysis. Leaving your days free to work etc.

[Daisy4246]

Hi
I did PD for 3 weeks and have to stop and do HD. Had an exit site infection.Then when that cleared a leak in the peritoneum. So the fluid went around my lungs and l couldn't breathe. It could happen again if l carried on. Reading this thread has helped me alot. I'm also nervous for the fistula and HD but we have to do it. Feels like one thing after the other. Hopefully things will settle. Good luck.