First off To beth; I understand that there are many factors that should be equated into mortality. I also understand that mortality is skewed because of the higher number of elderly dialysis patients. Why I was offended by your remarks about Kt/V and mortality. Because of the two aforementioned reasons for mortality. Also it sounded to me that you were suggesting that Kt/v has nothing to do with your overall health. I notice a change in how I feel with tenth’s of an increase in my Kt/V. That alone tells me that it has some importance. Do the clinics put to high of a stress on Kt/V and not other levels? Well with the number of patients and clinics being for profit. I don’t think they have the time to worry about any other real issues. That is sad and is why I am on home hemo. Even though when I am not part of the research group. They will go back to just testing the standard lab work. Now they are testing lots of stuff that they don’t regularly. Kt/V is a good measure for urea clearance and is a good way to judge adequate treatment. That is dialysis specific measurement. Diet and mental health are also a part of the treatment, but have nothing really to do with the dialysis clinic. Yes they do have a social worker and a dietician, but seriously they have never helped me much. My mental health is up to me and so is my dietary needs. So the clinic uses what it can to measure things Kt/V. Maybe some day, before stem cells, they will get their act together and think preventive care. Then they’ll use a broader scope to measure dialysis. Now it is Kt/v and I like to have mine as high as I can get it.
About CAPD/CCPD versus Nocturnal Home Hemo. I don’t think I ever had the dietary freedom on PD that I have on NHH. I am a foodie of sorts, I love to cook and I love to eat at nice restaurants. My range in cooking and the places and things I can eat has broadened alot on NHH. I think PD had a place in my life. I had some good years on it. I drove home to arkansas more then once, by myself on PD. I could not do that on NHH. Lifting the boxes got to be impossible after I had a few hernias though. I could camp out in the mountains by myself for days on PD. I could do the same things with a partner with my NxStage machine. So in a month or so we will be traveling to oregon and then I can realy compare the things about PD I liked so much. I am sure it will come down to alone or needing an assistant.
LSB