Monday morning first thing meet with my PD team at Fresenius Granbury, TX. All went well with my lab results mostly being within specs with the exception of possibly iron which may be supplemented next month.
I received a handout from the team’s dietitian which had an interesting statement, to wit: “Avoid heart catheters. PD does not last forever, so plan with your doctor to get an access placed for hemodialysis if you don’t already have one. … should you ever have problems with your PD catheter.” To me, this begs the question, “How long could one expect a PD schema to last?”
So off to Google where I found an interesting article from healio.com titled “Can peritoneal dialysis be a long-term therapy?” The following is excerpted from this source with my clarifying info in brackets.
PD does not necessarily need to be a short-term therapy, and it has longer-term potential if the patient avoids peritonitis, leverages lower hyperosmotic dialysate, and preserves residual renal function.
The main reasons for PD technique failure include psychosocial stressors, [Psychosocial stress is caused by situations that make us feel excluded, not good enough, or as if we don’t belong.] infection, catheter malfunction, inadequate dialysis, hypervolemia [Hypervolemia is a condition in which there is too much fluid in the blood.] and other medical conditions —e.g., uncontrolled diabetes, acute cardiovascular events, etc. Controlling reversible factors is critical to extending the time on therapy for PD patients.
Peritoneal membrane function may be extended by avoiding significant hyperosmotic [The term hyperosmotic is derived from the Greek words hyper, which means “excessive,” and Osmos, which means “push, thrust, or impulse.” ] glucose and uncontrolled diabetes; avoiding peritonitis; considering diuretics to improve urine output when possible to avoid hyperosmotic glucose solutions; and leveraging angiotensin [Angiotensin is a chemical in your body that narrows your blood vessels.] -converting enzymes, angiotensin II receptor blockers, and/ or aldosterone inhibitors to preserve both kidney and membrane function.
Historically, the ideal candidates for PD are individuals wanting to treat their kidney disease in the home and who desire to play a key role in ensuring optimal care results. These patients may be younger, but they can be of any age as long as they are interested in a home modality; employed individuals who want to stay working; and patients with residual renal function and interested in preserving urine volume.
So the answer to my question is, How long should one expect to be able to continue on PD? Is for a long time. This time is directly a function of:
- Keeping your catheter site clean as possible
- Being positive and in charge of your PD
- Keep on peeing.
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