This is just my personal opinion, but, having been myself in chronic renal failure for more than a decade, and on dialysis (hemo) for over 2-1/2 years, at this point, I think you should be limiting your consideration to choosing between hemodialysis and peritoneal dialysis, first of all. Within those two treatment methods, there are a few different varieties. For example, in peritoneal dialysis, you can do CAPD or CCPD. For hemodialysis, there’s the standard 3 x per week in-centre, 3 x per week at home, short daily at home, and long daily nocturnal at home.
I personally think it would be a lot to start learning how to do hemodialysis at home all of a sudden without every having been on hemodialysis, but some people do successfully. For one thing, you might not feel that well until you’ve been on dialysis a few weeks first, and learning home hemo is a lot of work.
You might start at the usual 3 times per week for 3-4 hours, and then, if it’s offered, you could choose to be trained for home hemodialysis. But nevertheless, if there are no limitations, limit yourself first to choosing between hemodialysis and peritoneal dialysis. After that, you can think of the different possibilites if available (home hemodialysis is not available everywhere at present).
Now, unless you have some obvious problem that precludes doing peritoneal dialysis (there are a few things that do or that make it less likely to succeed), your nephrologist should be referring you for some pre-dialysis classes where the treatment options are explained to you. After that, you would be more informed to make a choice, and the dietary aspects would also be explained. At the very least, you should be given some videos to look at or some kind of printed information.
Your creatinine isn’t that high, but, one reason a nephrologist refers a patient for a fistula is that if the patient is going to be doing hemodialysis, a fistula is the single best way of getting access to the blood. The only problem is that a fistula may take a good 4 months to mature before it can be used, and sometimes the initial surgery just doesn’t work, ie. the fistula never develops, and it has to be redone or fixed somehow. This takes time. So, assuming you’re going to be doing hemodialysis, the accepted practice when the nephrologist does things properly for his/her patients is to start the process of scheduling the fistula surgery 6 months and up to a year before the time the person is expected to need dialysis. So, I guess this is what’s happening in your case.
I don’t know though. If you aren’t even at the stage where you have been put on a “renal diet”, and you haven’t yet been told to start taking a phosphorus binder with meals, it’s a bit unusual that with a serum creatinine of only 3.2, dialysis is right around the corner. On the other hand, when mine was at that level, a year later, I was on dialysis. Luckily, as it turned out, my fistula surgery had been done exactly 6 months before, and it was more than ready when I started dialysis. Having to start dialysis is bad enough without having to do it via a catheter inserted in your chest or neck.
Pierre