Although studies on different dialysis treatments and survival have shown conflicting results, after appropriate adjustment, researchers found no "significant" difference in survival between Peritoneal Dialysis (PD) and Hemodialysis (HD) patients. Dialysis patients should consider a variety of treatment options to best suit their lifestyle. If you experience changes and feel the need for a more suitable dialysis modality (type of treatment) then you should not be afraid to go between in-center and the more flexible home dialysis options for superior health outcomes. Previous studies were inconsistent mostly due to insufficient and varying factors. Using comprehensive data on a well-defined patient cohort, the Finland study examined the association of dialysis modality with survival between Chronic Kidney Disease (CKD) patients.
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These findings suggest that dialysis patients should choose the dialysis treatment that best suits their needs. Survival analyses shows that PD is associated with several factors generally related to good health. However, CKD patients should understand that PD works well only if s/he is able to follow his/her healthcare team’s advice and treatment program. A person who chooses PD is much more independent and needs to pay close attention to infections as well as general dialysis treatment and communicate any problems or changes to his/her
Nephrologist. One advantage of PD is the patient does not have to travel back and forth to a dialysis center, except to visit his or her kidney care team once a month. This allows them much more freedom to travel. Also, patients have a more liberal diet with less fluid restriction. If you have some residual kidney function, PD may be the best treatment to help preservation of function.
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The majority of patients select traditional in-center hemodialysis because all the patient needs to do is get to dialysis and a nurse with a full staff will administer treatment from beginning to the end of dialysis. The dialysis center is a structured environment where patients know precisely how much time and on what days they will receive therapy so it can easily fit into many peoples' lifestyle. On non-dialysis days, the patients’ only responsibility is taking their medicines and adhering to their fluid restrictions. This treatment choice is viewed as advantageous for those patients who require a structured environment or have compliance trouble. The downside is there are strict dietary and fluid restrictions patients have to stick to.
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A mix of the two types of modalities is home hemodialysis (HHD). The advantages of home hemodialysis (day-time or nocturnal) include liberal fluid and diet compared to traditional in-center hemodialysis. Also, dialysis patients will have control over their own treatments and when they perform them. You have to go through an extensive training process and you must have a care partner with you when performing HHD. One important aspect is a patient must be comfortable placing their own needles.
Ultimately, KidneyBuzz.com believes that the best dialysis treatment is a very personal decision. Although there has been several studies commissioned to offer some general guidance, it is best to discuss this matter with you Nephrologist and determine which modality best suits your lifestyle.
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"Modality of Chronic Renal Replacement Therapy and Survival—a Complete Cohort from Finland, 2000–2009." Nephrology Dialysis Transplantation.