Kidney Options - Questions

Can I take a shower if I choose peritoneal dialysis?

You may take a shower with a peritoneal dialysis catheter after the initial healing period. Your doctor or nurse will tell you when, usually about 4 weeks. Tub baths are not allowed.

What type of diet will I be on if I am on Peritoneal Dialysis?

You will need to follow a special diet, but peritoneal dialysis patients have a more liberal diet than hemodialysis patients do. Your dietitian will review your individual needs with you on a regular basis, and help you plan your meals.

Can I keep peritoneal dialysis supplies outside?

Your supplies must be protected from the weather. They must be kept under cover and away from temperature extremes.

Where do they put the transplanted kidney?

The new kidney is placed in the lower abdomen or pelvic area.

How will I get the supplies I need for peritoneal dialysis?

Supplies will be delivered to your home on a regular basis. A nurse will order your first shipment. A customer service representative will call you to set up future deliveries.

How do I find out if I can have a transplant?

Every ESRD patient’s records are reviewed for possible transplantation. Some patients will be referred to a transplant center for further evaluation. Your doctor will review your options with you.

Can any dialysis patient get a transplant?

Not everyone is a candidate for a transplant. Strict criteria must be met to qualify.

How long will it take for me, or a caregiver, to learn to do the peritoneal dialysis treatments?

A nurse will train you at the dialysis clinic. The training period generally lasts 1-2 weeks, and does vary from patient to patient.

How long will I have to wait for a transplant?

No one can give you an actual time. This depends on many factors including your blood type, antibodies, and type of transplant (living or cadaver). You may need to do dialysis while you are waiting for a transplant.

How often will I need peritoneal dialysis?

Peritoneal dialysis must be done every day. Your doctor will determine your exact "prescription".

Does peritoneal dialysis hurt?

Peritoneal dialysis should be painless. A very small percentage of patients experience some discomfort when they first start.

Can anyone be a living donor for me?

No. A living donor has to meet certain criteria established by the
transplant center. A potential donor has to be evaluated extensivley.

What is a living donor transplant?

A living donor transplant places a healthy kidney from another living person into your body.

What is peritoneal dialysis?

Peritoneal dialysis is the removal of excess fluids and waste products through the lining of the abdomen (the peritoneum), which acts as a natural filter. A special fluid is placed in the abdomen. Waste products and extra water move through the peritoneum into the fluid. The used fluid is then drained and replaced with fresh fluid.

How long does a peritoneal dialysis treatment take?

A manual exchange takes about 30 minutes. If you are on a machine at night, the average time is about 8-10 hours, depending on what your doctor prescribes.

How will I get the supplies I need for peritoneal dialysis?

Supplies will be delivered to your home on a regular basis. A nurse will order your first shipment. A customer service representative will call you to set up future deliveries.

What is an "access"?

An access is the device used to deliver your dialysis. There are different kinds for hemodialysis, and a special type for peritoneal dialysis. Your renal healthcare team will help determine which access is best for you.

If I have a choice of doctors, what should I look for in selecting a doctor to take care of my kidney disease?

Kidney Disease isn’t something you can go and take care of yourself by taking vitamins, herbs, or the latest alternative therapy. You will find that you need a doctor to carefully manage your health care. So, yes, selecting the right doctor is very important to your maintaining your health.

You will need to select a doctor who specializes in kidney function and End Stage Renal Disease. This doctor is called a nephrologist. Work with your primary care doctor to select a nephrologist. The Kidney Options program can also help you find a nephrologist in your local community. Your primary care doctor and your nephrologist will work with you regarding your kidney disease.

Here are a few suggestions for choosing a nephrologist:

Choose someone you like. The doctor you choose will be your partner in managing your renal healthcare. You will have a professional working relationship comprised of mutual trust and respect.
Choose a doctor you can talk to, have confidence in, and feel positive about.
Choose a doctor who is open to all kidney options and will help you select the therapy that’s best for you and your family.
Choose someone who will listen to you. The more your doctor understands about you and your lifestyle, the better kidney option decisions you will make together.

What is ESRD?

ESRD stands for End Stage Renal Disease. This is the stage of kidney damage that requires dialysis or transplantation to maintain life. Another term for ESRD is kidney failure.

Is End Stage Renal Disease (ESRD) contagious?

No.

How will I know when I need to start dialysis?

Your doctor will tell you when it’s time to start. This decision will be based on your laboratory tests and how you feel.

Will my kidneys ever work again?

No, usually not. It is extremely rare for “chronic” renal failure to resolve.

I still make urine, so why do I need to start dialysis now?

Making urine is only part of what kidneys do. Your kidneys may a have limited function-but not enough to maintain life

What if I choose not to start on dialysis?

This is your right. If you choose to not have dialysis (or choose to stop dialysis), you will eventually die from complications from your renal disease.

What will happen if I miss a dialysis treatment?

Missed treatments allow waste products and extra fluid to build up in your body, which often leads to health problems. This is felt to be very risky.

What is an “access”?

An access is the device used to deliver your dialysis. There are different types:

PD Catheter-In peritoneal dialysis; a soft, hollow tube that goes into your abdomen is used to instill and drain a special dialysis solution.
Graft-In hemodialysis; surgical placement of a material between an artery and vein to create a circulator access.
Fistula-In hemodialysis; surgical joining of an artery and vein so that the vein enlarges due to the flow of arterial blood.
Hemodialysis catheter-a small, soft tube inserted into a large vein to create a circulatory access.

Are there complications that can affect my access?

There is a risk for infection and clotting with any dialysis access. You will be taught how to care for your access.

How will dialysis affect my family?

You will need your family for support as you begin dialysis. Your family will need support as well. Roles may change at home, and adjustments will need to be made. Your renal healthcare team is ready to answer questions, provide support, and offer encouragement.

Will I still take the same medications once I start dialysis?

Your nephrologist (kidney doctor) will decide what medications are needed once you begin dialysis. No new medications (over the counter or prescription by other doctors) should be taken without checking with your nephrologist.

Will I qualify for Medicare to help pay for the dialysis?

A social worker is accessible at each facility to assist you with Medicare and other sources that might be available to help pay for dialysis.

I have been told that I will get Medicare when I start dialysis. Should I cancel my current Insurance?

Do not cancel any insurance policy without discussing your options with your social worker.

I work, and am unsure if I will be able to continue once I start dialysis. Will I qualify for disability?

Your doctor will evaluate your health and type of work environment to determine if you can continue your job. Many dialysis patients continue to work. Sometimes, hour or duties may need to be decreased. If you are unable to work, your social worker will help you determine what benefits you are entitle to, and how to apply.

Can I remain sexually active once I begin dialysis?

Yes. Your are encouraged to maintain a normal lifestyle. Some patients may experience a decrease on sexual drive. If this becomes a problem for you, talk to your doctor.

I cannot drive. Is there help with transportation?

Your social worker will assist you with identifying available options.

What is hemodialysis?

Hemodialysis is the removal of excess fluids and waste products by the passage of blood through an artificial kidney. Blood is pumped outside of the body, through a filter. Extra water and waste products are removed. The blood is then pumped back into the body.

Does hemodialysis hurt?

Discomfort or pain may be experienced with insertion of needles prior to starting your treatment but is mild and gets better with time. The actual dialysis does not hurt. Some patients experience headaches, cramps, or nausea during the treatments but are mild and not constant.

How long does a hemodialysis treatment take?

Each patient will have a prescribed time. The average time ranges from 3-5 hours. You should plan additional time for assessment before and after your treatment.

Do I have an appointment time for hemodialysis, or can I come anytime?

You will have an appointment. You need to come on your scheduled days and time. If you are working, or have special needs, contact your social worker or nurse.

What should I bring to a hemodialysis treatment?

You may bring a pillow and blanket for comfort. You are encouraged to bring reading materials or a cassette/CD player with headphones. Once a month you may be asked to bring in your medications from home to be checked.

What type of diet will I be on if I am on hemodialysis?

You will need to follow a strict diet on hemodialysis to remain healthy. Mot patients will need to limit the amount of fluid they drink. Your dietician will review your individual needs with you on a regular basis, and help you plan your meals.

Can I eat and drink while on a hemodialysis machine?

You will receive instruction on your unit’s policy on food and drink. However, it is not advised because of the risk of hepatitis in the dialysis unit.

Can I take a shower or bath if I am on Hemodialysis?

You may take a shower or bath with a hemodialysis graft or fistula. If you have a catheter, you can not get this area wet.

Can I travel on Hemodialysis?

Yes. Keeping an active lifestyle, including travel is encouraged. However you must arrange in advance a clinic at your destination to receive hemodialysis. Your social worker will help you with this.

I have small children. Can they come with me to hemodialysis?

No. Although most dialysis facilities have a waiting room for family members, young children should not be left unsupervised.

Can hemodialysis be done at home?

Yes, for a select group of patients. You and a partner would receive special training at the dialysis clinic before starting home hemodialysis. Your renal healthcare team will help you determine if this is an option for you.

How long will it take to learn home hemodialysis?

This varies from patient to patient. The average time is about 6 weeks.