| Treatment |
Pro's |
Con's |
| Home Dialysis - Peritoneal |
| (CAPD) Continuous Ambulatory Peritoneal Dialysis (4-5 times/day) |
| (CCPD) Continuous Cycling Peritoneal Dialysis (6-8 hrs every nite) |
|
- Needs no machine for CAPD
- Fewer diet and fluid restrictions
- Portable for ease of travel
- Needle-free treatments
- Dialyze while you sleep
- Fewer peaks and valleys
- Doctor visits and labs performed once a month at a clinic
|
|
- Increased risk of peritonitis (abdominal infection)
- Requires space for supplies
- Potential weight gain
- Cycling machine needed for CCPD
- Plastic tube from abdomen may be hindrance
|
|
| Home Dialysis - Hemodialysis |
| Short daily (2-3 hours, 6 days/wk) |
| Traditional (3-4 hrs, 3 times/wk) |
| Nocturnal (6-8 hrs 3+ days/wk) |
|
- Flexible treatment time
- Doctor visits and labs only once a month
- Nocturnal allows dialysis while you sleep
- Dialysis in the comfort of your own home
|
|
- A machine is required
- Requires modifications to home electrical and plumbing
- Care partner required for needle insertion
- Must order and have room for supplies
- May have problems with fistula, AV graft not working
|
|
| In Center Hemodialysis |
| Standard (days, 3-5 hrs, 3 times/wk) |
| Nocturnal (nights, 8 hrs, 3 times/wk) |
|
- Dialysis centers are found all over the country
- Skilled health care providers with you at all times
- Don’t have to put in own needle
- Get to know other dialysis patients
- Immediate access to emergency care if needed
- Do not need to store supplies in your home
- Frequent access to your health care team
- Nocturnal dialysis allows more time for activities
|
|
- Fistula or AV graft surgically inserted
- Must travel to a center
- Disrupts work schedule due to fixed schedule
- Less privacy (Sleep with other patients for nocturnal)
- More ups and downs in how you feel
- Must maintain a strict diet and fluid restriction
- Must follow centers rules regarding food, visitors, cell phones etc.
|
|
Compatible Living Related Donor
Kidney Transplant |
|
- May be able to be transplanted prior to start of dialysis
- Shorter wait time for transplant
- Better genetic match lessens risk of rejection
- Transplant takes place at a convenient time for both donor and recipient
- Kidney usually functions immediately
- Improved health with more active lifestyle
|
|
- Psychological stress of having a family member involved
- Time involved for evaluation and testing process
- May be responsible for travel expenses, wages lost
|
|
Compatible Deceased Donor
Kidney Transplant |
|
- No longer need dialysis
- Improved health with more active lifestyle
|
|
- Wait time for kidney may be years
- Kidney may not function immediately
- Rejection rate higher
- May be responsible for travel expenses, wages lost
|
|
Compatible Living Paired Donation
Kidney Transplant |
|
- You receive a compatible kidney from a living donor other than a family member
- Kidney usually functions immediately
- May find a younger donor or a perfect 6-antigen match
- Multiple recipients can benefit with NEAD (Never Ending Altruistic Donation) paired transplant
- Shortens time on dialysis
- More recipients transplanted, less on waiting list
- Improved health with more active lifestyle
|
|
- Your family can donate, but not directly for you
- Will need to wait on dialysis while finding a match
- Not all transplant centers can handle multiple simultaneous transplants
- Complicated process
|
|
Incompatible Blood or Tissue Type
Kidney Transplant |
|
- Positive cross matched patients are now able to receive a transplant
- Improved health with more active lifestyle
- Shortens time on dialysis
|
|
- Not all transplant centers will accept highly sensitized patients
- More procedures (plasmapheresis, immune globulin therapy) are needed
|
|