KidneyCoach: ESRD Treatment Alternatives

Take care of your body. It is the only place you have to live.
— John Rohnert

Over 275,000 Americans rely on dialysis to live,  and nearly twice that number receive therapy for  End Stage Renal Disease (ESRD). Whether your dialysis is done in a center or at home, you need to learn to be your own  Best Advocate.  It is your duty to speak up and speak out about substandard or safety issues.  For example, ask about how to take care of your fistula such as washing, or holding or bringing irregularities to the attention of the healthcare providers.  Make sure you understand why the fistula is  more efficient than a graft, and better than the catheter in avoiding acquired infections.  Be intent on becoming a subject matter expert.

In Center Hemodialysis

60% of those who are dialyzed at a center is serviced by a large Dialysis Organization (LDO) such as, Fresenius or DaVita.    It  is done three times a week for between 3 and 4 hours a session.  The Nephrologist will normally determine exactly how much time you will be assigned each session.

Home Hemodialysis

Since healthy kidneys work 24 hours a day, and 7 days per week , some people prefer to treat themselves at home in order to get more dialysis time, and more effective cleaning of their blood.  In fact only about 8% actually trust themselves enough to dialyze at home although it is found that 30% are actually fine candidates for home dialysis.  This option is normally done 5 to 7 times per week for approximately 2 hours a session.  However, Nocturnal is an alternative that goes 8 hours at night while you sleep for 3 to 6 nights per week.


Here too some report  better outcomes such as improved blood pressure, lower use of EPO, and they generally feel better. This is due to less incidents of depression, and more energy. However, many do not like carrying around the extra fluid in their abdominal  cavity which is required for this treatment option.

Continuous Ambulatory Peritoneal Dialysis (CAPD)

Most people do three to five exchanges per day, and each exchange takes approximately 30 minutes.

Continuous Cycling Peritoneal Dialysis (CCPD)

Due to logistics or preference , some prefer the CCPD which uses a 25 pound machine (comes with a traveling case) called a cycler to do the exchanges while they sleep at night.  This is also called Automated PD.

Kidney Transplant

In some regions of the country, there is as much as a 7 to 10 year average on the transplant waiting list. Transplants should not be viewed as a cure because it is not.  It is another treatment option like those mentioned above.  A donor usually comes from a family member, friend, or a deceased donor (cadaver).   Do not put your life on hold while you wait for a kidney, but rather use the information such  as contained here, to live life to its fullest every day, while extending life itself.

Recommended Reading:

Glossary of Commonly Used Terms: Features definitions of terms found in the treatment of Kidney Disease.

The 5 Stages Of Kidney Disease: Kidney Disease is described as having five stages (Stage 1 to Stage 5) based on the percentage of kidney function remaining. Determine your stage and how to prevent further progression.

Success Tips: These tips will reduce the risks of  hospitalization and will generally improve your overall quality of life by addressing head on those issues that may worry you,  mistakes that are  commonly made, and misconceptions frequently held.

Monitoring Lab Results: Blood tests are taken routinely on a monthly basis, and though they may vary slightly from one lab to another, note the standard ranges for key tests. Identify strategies to manage test results and maintain a higher level of energy and health.

Kidney Community Resources: These organizations service the Kidney Community.