Why am I a huge fan of Peritoneal Dialysis?



I often get asked which type of dialysis is better - Hemodialysis or Peritoneal Dialysis? That question really has no standard answer. It's like asking someone which flavour of ice-cream is the tastiest? It depends on the individual. Some prefer Hemo while others prefer PD.

If you asked me which I prefer personally, I would unabashedly say PD. Why am I such a lover of PD?

I honestly hadn't heard about PD until after my failed transplant in 1998. When I was researching the internet, I actually stumbled across the term by chance. This says a lot about the way medicine is practised in India. "Kidneys are failing, get a fistula made" is the mantra here. When I read about PD for the first time, it almost seemed too good to be true. I decided to ask my doctor about it, half-expecting to be told that it was not available in India or that I wasn't suited to it. Imagine my excitement when he said that I could definitely go for it.

The next six years on PD, as I keep saying to many people I talk to, were the best during my life on dialysis.

There are many reasons I liked PD:

  • Less diet and fluid restrictions: I was not asked to restrict anything. I did four exchanges a day compared to many PD patients who do only three exchanges these days. This was a welcome relief from the severe diet and fluid restrictions I was asked to observe while on HD.
  • No needles: Who does not hate needles? The very thought of two thick needles in my arms is even today,  a huge put off for me. The best part about PD was that there was no need for needles.
  • No thrice weekly hospital visits: PD is almost always done at home. The whole effort of going to a hospital thrice a week for about five hours each time was physically and mentally draining, not only for me, but also for my family.
  • Independence: I did my exchanges and exit site dressing myself. This was very different from HD when you showed up at the hospital and surrendered completely to the centre staff. In PD, I had complete control. This does put a lot of responsibility on you. Some people like this, others don't.
  • Freedom to travel: On HD, I can travel only to places where there is a good centre. Also, five hours at a hospital, every alternate day, does not appeal to me on a holiday! With PD, I could travel easily. All I needed to do was to order the PD fluid bags to a place close enough to where I was travelling. The rest was a breeze. 
I was told later that PD worked best when you had some kidney function remaining. I had zero kidney function during my entire PD tenure. It worked beautifully for me. I think the big difference was that I did four exchanges. That is probably why it worked so well for me.

If there was a way for me to go back to PD today, I would close my eyes and take it.

Comments

Unknown said…
Hello! My name is Sindhu, I'm 23 years old and I just started PD a week back (after a failed transplant). So far, all the technicians in the HD ward kept telling me how I should have just got a fistula done and scared me about PD and the infection risk. I still chose this on n my doctor's advice and also because of several other factor such as thin veins and residual renal function. I just want to thank you for reaffirming my faith in my decision,when everyone else is scaring me about it.
Kamal D Shah said…
Good for you Sindhu. I’m glad your doctor advised you to do this. All the best.
Elga said…
Hi Kamal, my mom is paralyzed and so we are considering PD dialysis. How do we purchase the consumables for the same? They aren't available at normal medical stores right?
Kamal D Shah said…
Hi Elga, thanks for your comment. Where are you based out of? PD fluid is definitely not available in medical stores. It will need to be obtained from the company (Baxter, Fresenius etc.) directly.
Sam Sahil said…
Hi Kamal D,

In a similar case like yourself, I took the decision to go for Pd for my father. How much monthly expense does one have to bear for pd? Any government subsidized pd bags ?