Having kidney failure is not a death sentence.
There are several options available to people that need renal replacement therapy. In partnership with Davita, we offer a class at several locations that cover several aspects of renal disease including dialysis and transplant. Among the options for renal replacement therapy, a person has the choice of hemodialysis, peritoneal dialysis, transplant, and no treatment.
Hemodialysis – This type of dialysis requires the patient to have a vascular access called AV fistula or AV graft. Two thin needles are placed in the vascular access and blood is removed from the body by one needle and is ran through a dialyser or dialysis machine. Thin membranes within the dialyser remove waste and extra fluid from the blood. The blood is then returned to the body by the second needle.
Hemodialysis can be done in a dialysis center or at home. When a person choses to go to the center to have dialysis it is called in-center hemodialysis. This type of dialysis requires the person to go to a dialysis clinic three times a week. The schedule for dialysis is set and other appointments are scheduled around the patient’s dialysis schedule. Each treatment typically last 4 hours. Adjustments in treatment time is made based on lab values and the person’s overall well being.
Home hemodialysis is when the patient and a committed caregiver perform hemodialysis at home. The patient and their caregiver must receive training for about one month prior to being able to complete treatments at home. When doing home hemodialysis the patient will require more frequent but shorter treatments. Often a person is able to eat a greater variety of foods due to the frequency of dialysis.
Peritoneal Dialysis – This type of dialysis requires that a person have a flexible tube placed in the belly. One side of the tube remains inside the person’s body in the peritoneal cavity. The other end of the catheter is outside of the body and is used to connect the patient to the dialysis solutions. A person usually only requires 5-8 days to learn how to perform peritoneal dialysis. Peritoneal dialysis, also known as PD, is a very slow type of dialysis. Because of this a person should expect to do PD each day. Often this can be done at night while sleeping. However, some people require PD 24 hours a day and therefore must do an exchange of solutions during the day as well. The solutions used for PD are sugar based. This type of dialysis works slowly to remove waste and fluid from the body. It is usually the most well tolerated form of dialysis. The frequent dialysis results in less stress on the body, an increased variety of foods allowed and often a decreased fluid restriction. Travel with all types of dialysis is possible and even encouraged, however, with PD travel is very easy and requires the least amount of planning.
Transplant – Renal transplant is the prefered form of treatment for kidney failure. Due to the complexity of a renal transplant, only certain hospitals are able to do kidney transplants. In Alabama, the only center for transplants is at UAB, Other centers in this region are located in Florida, Mississippi, Georgia, and Tennessee. Georgia has Piedmont and Emory in Atlanta. Florida has many transplant centers. The two closest centers are Sacred Heart Hospital in Pensacola and Shands Transplant Center in Gainesville. Mississippi has only one center located in Jackson named Mississippi Kidney Foundation. Vanderbilt Renal Transplant is located in Nashville, TN.
After a person is referred for transplant, an evaluation occurs at the transplant center. At that time multiple tests are done to determine if the patient has the physical, emotional, and financial means to undergo transplant. The most successful transplants are from a living donor. Cadaveric donor kidneys are in a greater demand than supply. Often a person must wait years to have a renal transplant and will need dialysis while awaiting a transplant.