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  1. #1
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    Question Peritoneal Dialysis

    For those that have been on Peritoneal Dialysis, how long has anyone or someone you know been on this type of dialysis? Because my fiance does'nt want to have to be stuck by needle's Daily like when your on Hemo Dialysis.She's hoping she can be on this type untill she's finds a donor kidney.
    MdGuyS~

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    Re: Peritoneal Dialysis

    Quote Originally Posted by MdGuyS View Post
    For those that have been on Peritoneal Dialysis, how long has anyone or someone you know been on this type of dialysis? Because my fiance does'nt want to have to be stuck by needle's Daily like when your on Hemo Dialysis.She's hoping she can be on this type untill she's finds a donor kidney.
    MdGuyS~
    I was on Peritoneal Dialysis from Feb 2001 to July 2005 myself. I would have been on it longer but I got Peritonitis and had to switch to Hemo Dialysis which I was on until Nov 2007.

    I had a fear of needles and felt the same way as your fiancé. But it didn't go that way and I had to get a fistula in 2006. So I used Emla cream because I was afraid of the pain. It wasn't as bad as I thought it was. Not the cannulating itself (sticking). The part that bothered me was that sometimes staff couldn't get the angle of the needles correct in my arm or would hit a nerve.

    I still prefer Peritoneal Dialysis but now with all the scar tissue I have in my abdominal area I don't know if I ever could do it again. So I am glad that I know both types of dialysis are manageable for me. I still don't like needles but I was able to do it for 2 years before I got a transplant finally.

    As for how long someone can be on Peritoneal Dialysis? Well it all depends on the Peritoneum membrane. Everyone is different.

    Even though this is a UK link I found this information on, it is the only one that I was able to find this information at when someone else asked the same question as you only a year ago:

    http://www.kidney.org.uk/Medical-Info/pd/pdhowlong.html

    How long can I remain on PD?

    Some people have been successfully treated with PD for over 10 years. Generally, around half of the people who start PD stay on PD for around 2-3 years. Many will go on to have a transplant, or switch to haemodialysis. The reasons people transfer to haemodialysis vary from repeat episodes of infections, leaks of PD fluid or hernias, to being unable to cope with constantly doing exchanges. Availability of new PD fluids and a wide range of prescriptions on CAPD and APD mean that more people who choose to stay on PD can do so. Like people without kidney failure, people on PD die. The causes include heart disease (especially smokers), strokes, diabetic complications, or cancer. Survival on PD is affected by age, cause of kidney failure, other medical conditions, lifestyle (exercise, diet, smoking, alcohol intake, stress, compliance with treatment) and luck! Coping and determination are also very important factors, which determine how long people remain on PD.


    Will my peritoneum ‘wear out’?

    The peritoneum does not actually ‘wear out’, but in a very small number of patients it may cease to be effective as a dialysis membrane. It is thought that repeated episodes of peritonitis, and using a lot of ‘strong bags’ for a long period of time may affect the life span of the peritoneum.
    Angie
    Kidney KornerDialysis Ethics Forum Kidney PixAwareness Shirts KidneySpace Donor Search
    I will be walking a Kidney Walk in Ontario Canada Sept 18th 2011

    • Peritoneal Dialysis = 4 yrs
    • Hemo Dialysis (in center) = 2 yrs
    • 2 kidney transplants = 1990 - 2001 & 2007 to present

  3. #3
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    Re: Peritoneal Dialysis

    thank you, I hope that Karen finds a donor before having to hemo.
    And your reply brings up another question for me. Can peritonits be avoided or does that come with long treatment's of PD?
    Thanks for your quick reply,
    MdGuy~

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    Re: Peritoneal Dialysis

    Quote Originally Posted by MdGuyS View Post
    thank you, I hope that Karen finds a donor before having to hemo.
    And your reply brings up another question for me. Can peritonits be avoided or does that come with long treatment's of PD?
    Thanks for your quick reply,
    MdGuy~
    Yes it can be avoided but not always. It depends on circumstance. Take my situation for example. I was good at keeping everything sterile and not contaminating connections and keeping windows and doors closed and fans off and people out of my room when I did exchanges and to check bags and tubing for any leaks for the Cycler and didn't allow my cat in the room at all (even when not hooked up because of fur so she never was allowed in there). I always washed my hands and in 1990 when I did PD the first time around we used to have to wear masks and gloves until they changed that to washing hands for 2 full minutes and then added using hand sanitizer. I was very good. But my Peritonitis was caused by abdominal abscesses that had nothing to do with Peritoneal Dialysis. That was something that had nothing to do with anything I did so I could not prevent it. But usually Peritonitis IS caused by error via contamination so usually can be prevented.

    It is important to keep these things in mind for preventing infection with Peritoneal Dialysis:

    • Wash hands
    • Prevent air movement during connection by keeping Windows & Doors Closed as well as Fans OFF during exchanges (when hooking up / when exit site exposed)
    • Proper exit site care
    • Be aware of chance of contamination (do not move blankets just before connecting as dust could be stirred up and land on connection)
    • Keep pets out of the dialysis area.


    Also, I got this 2 years ago when I started dialysis. It's what to do if your exit site is irritated.

    Exit site infections can lead to tunnel infection, peritonitis, and catheter loss.

    Routine care, examination of your exit site and tunnel area daily, and prompt reporting are every day tasks.

    Hypertonic Saline (salt water) soaks will help get rid of irritation, tenderness, light redness, and crusting. Salt water soaks are to be done for 10 minutes daily to maintain healthy skin around your catheter.

    RECIPE for SALT WATER SOAKS:
    1/2 cup of warm tap water in a cup
    1 heaping teaspoon of table salt
    Swirl solution until salt is dissolved

    Take a 4x4 gauze pad, dip into cup, and squeeze out until just slightly "drippy" and wrap it around your catheter so it is right against your skin.

    Protect your clothes with a blue pad and hold the gauze pad against your skin for 10-15 minutes.

    Remove damp gauze and let exit site air dry.

    Tape catheter securely and replace dressing if needed.

    It is important for air to get to your exit site. Keep the tubing well taped and secured. A dressing is not always needed.
    Infection of the peritoneum can happen for a variety of reasons.

    Pronounced: peh-rit-oh-NYE-tis

    Definition:
    Peritonitis is an inflammation or infection of the peritoneum. The peritoneum is a thin tissue lining that covers the inside of the abdominal cavity. It also covers the outside of the intestines and other abdominal organs.

    There are several types:


    • Primary
    • Secondary
    • Peritoneal dialysis related

    Peritonitis is a serious condition. It requires immediate treatment. If not promptly treated, it can be fatal.

    Causes:
    Primary peritonitis--occurs when there is a buildup of fluid in the abdomen (not related to dialysis). This is called ascites.

    Secondary peritonitis--caused by bacteria that enter the abdominal cavity. Can be due to an injury or a condition, such as a ruptured appendix (or exit site contamination)..

    http://www.mayoclinic.com/health/per...SECTION=causes

    http://www.cnn.com/HEALTH/library/pe...s/DS00990.html

    http://www.ncbi.nlm.nih.gov/pubmed/17080111

    http://www.aakp.org/aakp-library/Peritoneal-Dialysis/

    http://www.bt.cdc.gov/disasters/icfordialysis.asp

    http://www.bt.cdc.gov/disasters/pdf/icfordialysis.pdf

    http://www.medscape.com/viewarticle/553665_2
    Angie
    Kidney KornerDialysis Ethics Forum Kidney PixAwareness Shirts KidneySpace Donor Search
    I will be walking a Kidney Walk in Ontario Canada Sept 18th 2011

    • Peritoneal Dialysis = 4 yrs
    • Hemo Dialysis (in center) = 2 yrs
    • 2 kidney transplants = 1990 - 2001 & 2007 to present

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    Smile Re: Peritoneal Dialysis

    Quote Originally Posted by MdGuyS View Post
    For those that have been on Peritoneal Dialysis, how long has anyone or someone you know been on this type of dialysis? Because my fiance does'nt want to have to be stuck by needle's Daily like when your on Hemo Dialysis.She's hoping she can be on this type untill she's finds a donor kidney.
    MdGuyS~

    Yes, Angie has given you the true low down on PD and the proctocol that surrounds it, but there is one other thing that is very important, you must stay regular, meaning don't ever get constipated, and also if you develop diarrhea, check it up as soon as possible, because these are other developments that can lead to peritonitits. Now, your question on whether a pt can live a long productive life on PD, well I am in my 10th yr. and I am doing fine, thank God!, but it wasn't always like this, in my 5th yr. of PD, I developed a fungus, and had to return to hemo for about six months, until my peritoneum healed properly. I developed this infection from having to connect and disconnect during a stay in a hotel. Usually a rule I have at home, is to not disconnect, once I started my cycler treatment at night, and it was working fine for me. Prior to taking that trip I had a biopsy (a picture that surrounds a female health issue), but I don't think that is the only thing that contribute to me developing this infection, My husband and I took a trip to his hometown in New York, and he was anxious to visit Ground Zero, where the twin towers were hit in the 911 attack. Going there I could see crystal like particles just floating in the air, and it wasn't long after I we returned to the hotel, that I began to feel ill. I had just started my cycler treatment, when I had to immediately disconnect, (because my tubing didn't reach the bathroom), I was experiencing bodily issues at both ends, you know vomiting and diarrhea), it kept happening for three of my exchanges, until I finally decided to disconnect and promptly do manual exchanges. So, you see like another pt. mention on this forum, it truly depends on the pt and whatever situation they are in at the time. I wasn't very happy about returning to hemo, because it was impossible for me to have a new AV Graft, and of course because of the ordeal that I faced 10 yrs. before w/AV Grafts and repairs, I could no longer have catherer or subclavians in the upper part of my body, I was forced to have a catherer placed near my groin, and I had my problems with that catherer, there were times when it was difficult to have my full treatment that day, I was always coming back the following day for continued treatment to complete my session. As you know I was not pleased with this, as this catherer would only get as high as 250, and that pressure is way too slow to do a 3 1/2 hr. hemo treatment. So, what I am saying is that PD is great, when the PD catherer is safe and clean always and that you follow the rules to a T. When I first started PD, a fellow pt. was on PD, and I kinda learned from her what to do and what to expect? I wanted to be a model PD pt. so I decided to creat a chart that I could put in a frame and place on my wall (it was in red marker) , to refer to, to make sure that I follow every step in doing the PD preparation and procedure. I did this for about six months, until I was to be trained on the night time cycler machine, and I creat another chart for that night time procedure on the back of the same poster board, and I now I can say after two years of cycler treatment, I finally took that chart down, because I am now confident in the way I do PD. I did have to put it back up for a short period of time, when I transition back to PD, because I had become very rusty with PD, while on hemo. Like others on this post said, everyone is different. But another thing that is important is that, you shouldn't have to use the strongest solution - 4.25, but every once in awhile, because using it consistently could damage the pancreas, because there is an excessive amount of dextrose in this 4.25 bag of solution, you know dextrose (sugar), I hope that all of us that have responded to your concerns about PD regarding your fiance, will help you and your fiance get a better prespective on how convenient and easy PD is, but I must say because I have experienced both forms of dialysis treatments, they both have advantages and disadvantages. And of course, it is way too much to go into on this post, maybe another time, if you request to know.

    Glo

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    Re: Peritoneal Dialysis

    Oh I have a question for you too Glo! When I had to switch to Hemo from Peritoneal, for months I had developed diarrhea. They told me it could not have been related to the cause of the Peritonitis but because of what you said here..
    you must stay regular, meaning don't ever get constipated, and also if you develop diarrhea, check it up as soon as possible, because these are other developments that can lead to peritonitits.
    .. I wondered, can it and how can it lead to Peritonitis? I have always suspected but my local city's hospital is not the best. It wasn't until 3 years later when I went to my transplant hospital after having a transplant and my immune system being suppressed (and the pain I had got worse) that it was discovered that I had abscesses and that it might have been the cause of my Peritonitis back in 2005 (but can't be verified). So now I am wondering, with what you said, if you could maybe help me shed light on the cause.

    I know my situation was not typical but actually quite rare. Thank you for bringing up very important points I completely forgot about. I had no idea you were on PD that long! That is inspiring!
    Angie
    Kidney KornerDialysis Ethics Forum Kidney PixAwareness Shirts KidneySpace Donor Search
    I will be walking a Kidney Walk in Ontario Canada Sept 18th 2011

    • Peritoneal Dialysis = 4 yrs
    • Hemo Dialysis (in center) = 2 yrs
    • 2 kidney transplants = 1990 - 2001 & 2007 to present

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    Re: Peritoneal Dialysis

    Angie,
    You have really helped us understand PD. What can be done to reduce the size of the belly?

  8. #8
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    Lightbulb Re: Peritoneal Dialysis

    Quote Originally Posted by fly1943 View Post
    Angie,
    You have really helped us understand PD. What can be done to reduce the size of the belly?
    Hmm.. interesting question. Going solely by personal experience, all I can think of is keep your stomach muscles strong. I noticed with the weight of the fluid, the belly hangs out and forward, but if your stomach muscles are strong I would think that would make it stick out less. Not matter what it will stick out a little because of how much fluid, but just keep remembering that you are alive because of dialysis which is amazing because at one time there were committees that decided if you were privileged enough to get dialysis or had to go without til you passed on or got a transplant. We are very lucky to have all this medical technology available to us. Of course we care about the looks of our bodies. Heck, with the media and people's perception of what beauty is, it is hard to ignore any effects on our bodies due to medical procedures.

    I got so depressed at first with stretchmarks from my first transplant actually. Now years later, I don't care about the scars or the fistula. Yet for some reason the stretchmarks still bother me. I think it is because at that time I was only 16 and the hatred I had for my stretchmarks will never go away even though they did get duller. But as I got older, the other things that happened to me, I had a different outlook on. I knew all this was medical and saves my life. It no longer was a negative thing. So I never once hated my fistula. I just look at it with interest and awe that it is apart of my body.

    The same thing goes with the PD belly (as I call it). It all depends on how you look at it. Just like a pregnant lady might either hate her growing belly or admire that something amazing is happening. It is all just in a matter of how you are perceiving it.

    I don't know if this advice really is helpful. I learn as I go along myself and am amazed where life has taken me. I hope that you won't look at anything that happens or has happened to you negatively but realize that you fit in here and are one of us! We have all been there! Join the club! lol

    Heck I didn't have the courage to wear a bikini on PD but Shay did! She has a picture of it on www.kidneyfun.net ! I was amazed she had the guts but I think she said once that she lives where it is hot. No way she was gonna let a little tube and a little bit of belly hold her back! She was 19 when she said that. She is now 22 I think. Words to live by. Don't let any belly hold you back!
    Angie
    Kidney KornerDialysis Ethics Forum Kidney PixAwareness Shirts KidneySpace Donor Search
    I will be walking a Kidney Walk in Ontario Canada Sept 18th 2011

    • Peritoneal Dialysis = 4 yrs
    • Hemo Dialysis (in center) = 2 yrs
    • 2 kidney transplants = 1990 - 2001 & 2007 to present

  9. #9
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    Re: Peritoneal Dialysis

    Hi Guy,

    I've been doing PD for 5yrs and 10 months now. I personally know a gentleman who did PD for 13yrs (no infections).

    I truly do recommend PD because of the flexibility as far as diet and fluid intake is concerned, compared to HEMO.
    But you have to keep in mind, PD is not for everyone and it does require a bit of work and discipline.

    It's well worth the work if you can feel well most of the time.
    I received the GIFT OF LIFE on Nov 9, 2010 thanks to my wonderful donor Laura and her family!

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    Smile Re: Peritoneal Dialysis

    Hi Marina, I see you live in San Francisco, I reside in Fairfield, Well anyway, I am in my 10th year of PD, and you are right, it is less taxing on the body than hemo, but I had to learn this the hard way, you see when I started dialysis, PD, was not offered to us, we had no other choice but to go on hemo. And of course, I have had my drama with hemo, especially with the fact that I had to have an AV Graft, because of my very small veins. I had so much trouble for over ten years on hemo, with numerous Grafts (4 total), and repairs with angioplasties, and angiograms. Finally it took its toll after my fourth Graft that was placed in the upper part of my left thigh. It failed so severely, that I had no other choice but to transition to PD, but to be honest with you, I sure wish I wouldn't have gotten so many Grafts, because since I have been on PD, I have had so many problems with getting my blood drawn, and of course IV. It is so bad when I am in the hospital, that I have to have an IV either in my foot or neck, and I truly don't like that. You see, because of all the access and catherers (subclavians), I had very severe swelling, to the point that I was coming to the unit so severely swollen, that the techs had the hardest time determining what was excessive fluid and what was appear to be edema, it was truly a guesting game, what was my dry weight? That is one reason why I have so much problems with blood draws and IV. Well as far as my history of infections with PD, I have had two during my 10 year run, and I didn't get these infections while doing treatment at home, it was always when I was on a trip of some kind, and I end up getting sick on the trip, and had to connect and disconnect during the night, because the hotel bathroom was never close enough so that I could get to the bathroom without disconnecting. I stay connected during the night when I am at home, because my PD nurse told me early on, that the connecting and disconnecting from the cycler, you can run the risk of developing peritoniitits, (I hope I spelled that right), but knock on wood, I haven't had an infection in five years, and I hope that I never have another one, because having that infections, brings very excruiating pain. All in all, just being very sanitary with the cleansing of the catherer, will keep a PD pt. from that pesky peritonititis. Just felt like sharing this, and hope it can enlighten other PD patients.

    Glo

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