How to decide which mode of dialysis is right for you? [Dr. Spinowitz]

Q: How to decide which mode of dialysis is right for you?

A: Of the many functions that the kidneys have in the body, some of the major functions are to get rid of the toxins that are built up in the bloodstream and to maintain a balance of fluid and electrolytes. If somebody’s kidneys decline in function, the patient will require dialysis to achieve these effects.

The patient will have to discuss with their nephrologist, family, and support system what mode of dialysis they will require. There are two different modes. One is peritoneal dialysis and the other one is hemodialysis. Sometimes patients come to me to review the pros and the cons of each mode of dialysis. Again, these decisions will need to be made with the primary nephrologist, the patient’s family, and support system. The decision is very complex and will be very subjective. It will depend on the patient’s lifestyle and what they want to achieve.

A pro for peritoneal dialysis is to gain independence. The patient can go about their daily life with peritoneal dialysis because peritoneal dialysis can be performed at home, or at night. This leaves the day for the patient to do whatever they normally do, whether it’s work or travel, or just go on with their daily business. A con for peritoneal dialysis, as patients have told me, is that they don’t like their home to look like a hospital. They need to store some of the bags for the peritoneal dialysis and then have a place to dispose of everything.

A pro for hemodialysis is that the patient can go to a dialysis unit, and the dialysis unit, with the nurses and technicians, can perform hemodialysis for them. A con of hemodialysis is that a patient will require cannulation, or sticking a needle into the fistula or the graft, which is underneath the skin, to achieve hemodialysis.

Once the decision is made as to which mode of dialysis the patient will undergo, the patient can be sent to a place like ours here at Queens Endovascular Center, where the appropriate procedure can be performed so that the patient can receive either peritoneal dialysis or hemodialysis. If they will require peritoneal dialysis, the patient will require a peritoneal dialysis catheter to be inserted into the abdomen. If the patient will require hemodialysis, the patient can initially require a hemodialysis catheter to be placed in the chest or to have a fistula or graft created underneath the skin for dialysis.

More videos from the interview with Dr. Spinowitz of the Queens Endovascular Center as he explains the different modes of Dialysis Access Management:

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