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Sunday, June 15, 2014

Peritoneal Dialysis Frequently Asked Questions Part 2

This is Peritoneal Dialysis Frequently Asked Questions Part 2
Click here for Part 1
Click here for Part 2
Click here for Part 3
Click here for Part 4

4. Is Peritoneal Dialysis a painful therapy?
Contrary to hemodialysis, there is no needle involved in peritoneal dialysis. As such it should not be painful. Occasionally, after the dialysis catheter is inserted, abdominal discomfort may occur for one week. If discomfort continues, adjustments can usually be made to your dialysis exchange. Always report pain or discomfort to your doctor or nurse. Pain at the exit site or around it can mean skin infection or even more importantly peritonitis. If you start having pain or abdominal discomfort, you should notify your peritoneal dialysis team. They will obtain culture of abdominal fluid and try to treat you accordingly.

5. Will my kidneys ever work again?
The answer to the question depends to what was the underlying reason for kidney loss. Some patients have had chronic kidney disease for many years, and now, their disease has progressed to end stage renal disease. On the other hand, some patients has had acute kidney injury and may recover some kidney function. Some of the patients on dialysis still make urine. This does not mean that they can come off of dialysis. One of the most important issues is to prevent further deterioration in kidney function. This requires close follow up with dialysis team and avoid any medications that can cause kidney damage such as contrasted imaging.

6. I still make urine, so why do I need to start dialysis now?
Kidney's job is to control your body's fluid status, correct your electrolytes, and get rid of toxins. Making urine is only part of what kidneys do. Dialysis will help you to get rid of extra fluid, balance your electrolytes and more importantly get rid of toxins. Many patients, at first, are hesitant to start dialysis. They associate dialysis with death and pain. However, many of these patients start feeling much better after few sessions of dialysis. This is because dialysis helps to remove many toxins from their body that had been gradually accumulate with decrease in kidney function. In addition, once patients start on dialysis, they start feeling bette, more energetic, and can continue their normal activities. Make sure you ask your dialysis team to refer you to transplant center as soon as possible to be evaluated for kidney transplant. Also make sure to ask around from friends, family members, and church people to see if they like to be a donor.

7. What will happen if I miss a dialysis treatment?
This depends to the patient's residual renal function and whether the patient does hemodialysis or peritoneal dialysis.  Missed treatments allow waste products and extra fluid to build up in your body, which often leads to health problems. Peritoneal dialysis patients are on dialysis seven days of the week. As such peritoneal dialysis patients fluid status is much better that hemodialysis patients. Also toxins are removed in continuos manner vs hemodialysis patient that receive dialysis 3 times per week. If you are going to miss a dialysis session you need to inform you dialysis team.

This is Peritoneal Dialysis Frequently Asked Questions Part 2
Click here for Part 1
Click here for Part 2
Click here for Part 3
Click here for Part 4



Ardavan Mashhadian D.O.
Nephrologist
1127 Wilshire Blvd Suite 510
Los Angeles CA 90017
(213) 537-0328