I have been under the care of a specialist for about 2 1/2 years. During a recent visit he reported my blood creatinine level had gone from 2.1 to 3.2 and he said I should think about scheduling a precedure to create a fistula and start looking for a suitable center to begin dialysis in the near future.
After the shock subsided I searched the internet and found this site among several that addressed my concerns. After reading some of the postings here I am still somewhat confused. What reasdon could my doctor have for determining that a fistula access and in-center 3X a week dialysis is the correct (and only?) option for me? From some of the postings here it would seem there are alternatives to in-center procedures (at home frequent short duration treatment) that are not only superior to in-center but more convenient and flexible.
In addition I am trying to find answers to some questions I cannot find on the net.
-I assume dialysis is not particularly selective in the compunds it removes for the blood. How does this influence the treatments and medications one needs for other conditions?
-What are the typical diet restrictions?
-What are the infusions and IV’s mentioned in some of the posts and articles I have read?
-What is a phosphorous binder and why is it needed?
Sorry for the lengthy tome here but I am hoping one of you can shed some some light on my confsion.
Many doctors have little experience or training with home dialysis (PD or hemo). Because of this, they assume that all patients will do in-center hemodialysis and will need a vascular access (fistulas are the first choice of vascular access). Patients surveyed after they started dialysis have shown that few were informed about home PD or home hemodialysis. Unlike you, they just did what their doctor suggested without looking up other options. Patients that seek out education and participate more in the decision-making about treatment type and managing their illness do better so you’re on the right track already.
Dialysis (both PD and HD) remove toxins and fluids from the body. The dialysis solution that is used with PD or HD is designed to remove specific things. Some things cannot be removed well enough so patients must limit their food and fluid intake.
Most dialysis patients have to limit fluids, sodium, potassium, and phosporus. How much people need to limit these things depends on their body and the type of treatment they choose. Patients often need to take a phosphate binder (a medicine to bind phosphorus from food and get rid of it in the stool). Phosphate binders keep calcium and phosphorus in the right balance to avoid bone disease which is a complication of kidney disease.
Kidneys do much more than just get rid of urine. To learn more about kidney disease and treatments, check out Kidney School (www.kidneyschool.org). I’d also suggest that you look at the comparison chart on the home page of this site under “types of treatments.”