Dialysis Options
Welcome to our “Dialysis Options” page! In 2011 there are many options for patients facing treatment to replace sick kidneys. We believe that our patients need to be aware of each option so that YOU can decide what is best for you and your family.
We feature “IMPORTANT TO KNOW” sections periodically throughout the dialysis information page. These sections highlight the latest research developments regarding each of these dialysis options.
Dialysis is a process where fluids and other chemicals in your body are removed when your kidneys are no longer capable of doing this. There are many different types of dialysis for patients who have kidneys that do not work anymore.
There are over 600,000 people in the United States who are on a form of dialysis. There are 4,000 in Connecticut alone! You are not alone.
Kidney Decision Aid: (Click here for a guide for people who have, or know someone, with chronic kidney disease, and to aid in the decision about which treatment best fits into your life.)
HEMODIALYSIS
Hemodialysis is a type of dialysis where your blood gets filtered by a machine. Typically, this is done by placing 2 needles into a shunt in your arm. The blood then gets filtered through a machine and returned to you. The treatment lasts between 3 to 5 hours and is performed 3 times/week.
You need to prepare for hemodialysis by having a shunt placed in your arm. The shunt is called an arteriovenous fistula. You will be referred to a vascular surgeon for this procedure. The shunt is placed in a one-day surgery center and most patients are discharged home immediately following the procedure. The shunt will be ready to use in approximately 6 to 9 weeks.
Most patients who choose hemodialysis go to a center for the treatment. We have 4 centers in the New Haven and greater New Haven area. (Water Street, New Haven; North Haven, Milford and Branford).
We also offer an in-center nocturnal hemodialysis program at our Milford unit as well as a home hemodialysis program where patients are trained to perform the procedure at home.
Nocturnal Hemodialysis
Nocturnal dialysis is performed at night. Currently we have a shift of patients who receive this intensive therapy at our Milford unit three times/week. Each session is 8 hours long compared to the traditional 4 hour sessions.
Patients arrive at the unit by 7pm and come off at 4am. Most of these patients get right off of the dialysis machine and go straight to work feeling rested and ready for the day.
Patients who choose nocturnal dialysis do so for a variety of reasons. Some patients gain a lot of fluid weight between treatments and this helps to remove a lot of fluid without the patient getting crampy or tired. Also, some have high phosphorus levels that are difficult to control with diet and medications. Nocturnal dialysis helps to remove more phosphorus than the traditional session does. Most patients choose the long, nocturnal dialysis session because they feel so much better than they did on traditional dialysis.
You can discuss this option with your care team. We are always ready to offer this option to any patient who is interested.
Home Hemodialysis
Hemodialysis can be performed at home as well as in the center. Patients who do this perform the entire procedure from set-up to needle insertion to take off at home at their own convenience. The patient and another adult are both trained in the process and the proper equipment and supplies are shipped directly to your home. These treatments are done 6 nights/week and last bewteen 2 and 3 hours.
There are many helpful websites with more information about hemodialysis and shunts. Click on any of the links below for more information.
National Kidney Foundation: Hemodialysis
Home Dialysis: Home Dialysis Central
National Kidney Foundation: Home Hemodialysis
LiveNow: Rethinking kidney disease, many patient testimonials
**IMPORTANT TO KNOW: Patients On Nocturnal Hemodialysis Do Better Than Patients On Standard Hemodialysis
A recent study showed that patients who go to nocturnal hemodialysis have better blood pressure, better lab values, may live longer and have fewer hospitalizations than do patients on standard hemodialysis. Discuss this with your care team to see if you may benefit from this option.
For more information on this article, click here.
**IMPORTANT TO KNOW: Patients On Longer (Nocturnal or Daily Home) Hemodialysis Have Better Hearts
A recent study looking at many studies found that the size, shape and strength of the hearts of patients who receive daily hemodialysis, or for extended periods, such as in our nocturnal hemodialysis program, is better than for patients who receive shorter treatments.
For more information about this study, click here.
PERITONEAL DIALYSIS
Peritoneal dialysis is another type of dialysis therapy that is different than hemodialysis. This is a type of dialysis where a catheter is placed into your abdominal space. Fluids are put into this space and then drained. Extra fluid and chemicals are removed during the draining procedure.
This procedure is done at home and performed by you. Most patients use a machine called a cycler to do the process while you sleep. Some patients perform the process manually throughout the day. Peritoneal dialysis is performed 7 days a week.
You will have a special catheter placed by a surgeon to perform peritoneal dialysis. This is placed in the out-patient setting. Your catheter will be ready to use in just 2 weeks after being placed.
You will receive special care from our peritoneal dialysis nursing staff while your catheter is healing and then start training. You and your family/friends are each trained to perform the procedure at home. Training lasts for about 2 weeks with staff available 24/7 to help you with any needs.
American Association of Kidney Patients: Peritoneal Dialysis
National Kidney Foundation: Peritoneal Dialysis
LiveNow: Rethinking kidney disease, many patient testimonials
**IMPORTANT TO KNOW: Patients Who Need Extra Protein Can Now Get High Protein Dialysis
This study showed that it is safe to give patients amino acids (protein building blocks) via their dialysis treatments in the dialysis fluid. This also cuts down on the amount of glucose the patients are exposed to, which is a good thing as well.
For more information about this study, click here.
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Kidney transplantation is another option for patients with kidney disease. Some patients are even able to get a kidney transplant without ever starting a form of dialysis. Please vist our kidney transplant page for more information about kidney transplantation.
We also offer group educational seminars at no cost for you and your families and friends. You are encouraged to attend these sessions to learn more about the many dialysis options.
Making the choice to start hemodialysis or peritoneal dialysis can be difficult. We provide this information for you as a supplement to information you receive at our office.
We are always available to discuss these options with you and your family. You can meet with our nurse educator at any time for individual sessions to learn about the many types of dialysis we offer. You, your family and friends are strongly encouraged to attend these sessions.
