Will & Well-being: Advantages of home dialysis.

Things you want to know:

Some of the by-products, entering circulation during the consumption of energy sources are harmful to body. They must be eliminated so to maintain sustainable body functions. They can be ;

1) Excessive fluids

2) Overload of electrolytes

3) Carbon dioxide (removed from lungs through exhalation)

4) Nitrogenous waste; Urea and uric acid. Phosphorus.

5) Bile and bile products ( removed through GI tract and Kidneys.)

Circulatory system, neuronal system and urinary system are hampered if these start accumulating in circulation. When urea ,uric acid and phosphorus level rises, it poses a

serious threat to life.

What happens when your kidneys fail to function normal?

The major roles of your kidneys are;

Keeping electrolytes in balance , which is lost in ESRD.

Remove the nitrogenous by-products such as Urea and Uric acid.

Accumulation of urea and uric acid is life threatening. Accumulation of these, particularly urea effects brain activity as well as producing anemia.

Elevated phosphate levels occur, can hurt the heart!

Once ESRD established, what next?

You will decide your own modality of treatment. The option will be given to you by your attending doctor. The present focus for your dialysis requirement is based on enhancing your standard of life.

Tell them what is best.

The advent of modern dialysis equipment has made life take a u-turn for ESRD patients, patient with chronic renal failure. There are nearly 20million Americans who are at chronic renal failure stage. Still 50,000 deaths been recorded each year because of renal failure effects and its complication.

What is health care providers responsibility?

Once you are diagnosed with ESRD, now it is compulsory on healthcare provider to explain you all treatment options. The rule has been promulgated since 2008. The main emphasis is to be focused on home dialysis now. This is based on strong fact that a normal person removes waste liquid daily.

The two modalities being practiced are, home Peritoneal and hemodialysis.

How you do it?

A surgeon makes an arterio-venous connection which at the time of hemodialysis is connected to dialyzer .In home peritoneal dialysis a tube is placed in peritoneal membrane of abdominal cavity and placed at side of body, later to drain bag. These are very simple procedures.

How your life clinically benefited with home dialysis?

1)You are traveling to have your fluid waste removed at in-patient setting, is done with. That carries so much risk on life and over all stress. HR-QOL (health related quality of life) is found to be enhanced as you adopt on to home dialysis, both Peritoneal dialysis method or using home hemodialysis. It has been proved statistically that home dialysis

will give you new lease of life.

2) You are trained to handle your liquid waste removal by yourself. The machines are easy to operate once you are trained on them by qualified staff from clinic. You are not waiting in line. There will be no stresses of post dialysis exhaustion and fluid depletion. Your fluid restriction will be minimal. The serum phosphate rise which use to develop at in-centre dialysis is no more. So as the diet freedom you get when you opt for home dialysis.

3) Clinical studies have proved beyond doubt that dialysis during day, six times weekly or nocturnal (nightly )dialysis three to six times /week has lead to fewer hospitalization and lesser medication for your blood pressure control. Elevated phosphate has been cause of concern of death in dialysis patient due to cardiovascular reasons. With increase in frequency of dialysis at home, this risk has been eliminated.

Avoidance of side effects as muscle cramps and exhaustion due to loss of large amount of fluid and electrolytes.

4) The dialyzer are now available which can be managed at home and during traveling. Nxtstage is one machine getting FDA approval. Similarly night time dialysis has been made available in patient choosing hemodialysis, as well as peritoneal dialysis. Just get connected to hemodialyzer if you have chosen hemodialysis or Cycler for nocturnal

peritoneal dialysis. Its an automated machine which fills your peritoneal membrane with PD solution and drains the waste liquid, while you are still at sleep

5)There is overall marked improvement in your sense of wellbeing, sleeping patterns improve, heart function stabilizes. You start feeling more energetic, less nauseated. Your perception of being sick is eliminated with freedom to chalk out timings of operating the dialyzer. As energy is regained, you indulge in your work place as good as normal. Appetite improves, greater independence in health control.

6) Social life is improved markedly when you dialyze 6-8 hours at night. You can spend whole day free from any tiredness, enjoy gatherings with friends and neighbors at week ends., and even go on air travel to meet your family members.

7)Home dialysis is less costly than in-center dialysis. It amounts to nearly $US20,000 less/patient/annum. Medicare is providing expenses for home dialysis as for in-center dialysis.

You can handle all:

The training time for home hemodialysis needs three weeks, whereas for peritoneal dialysis it takes three and half days.