When faced with kidney disease and the need for renal replacement therapy, most people are overwhelmed.Itis difficult to decide which therapy is best.

Initially, most patients are treated with hemodialysis at a dialysis center.Hemodialysis is safe, effective, and well tolerated by most patients.Patients are usually treated three times a week at the same timePatients on peritoneal dialysis start their treatments at a peritoneal dialysis center or unit.

The dialysis staff begins the treatment and trains the patients to perform their own dialysis treatment. This training takes several weeks.Most people can learn how to perform the peritoneal dialysis exchanges.

Patients usually require 4 exchanges a day, 7 days a week.Because peritoneal dialysis is done 7 days a week, fluid and poisons are removed continuously every day.This continuous treatment allows an increased intake of fluid and a more varied diet.

Hemodialysis treatments are typically three times a week. Between hemodialysis treatments, fluid, potassium, salt, and phosphorus intake must be limited.Another advantage of peritoneal dialysis is the ability to vary your dialysis schedule by changing the time or the location of your exchanges

Peritoneal dialysis allows greater flexibility of travel because there is no need to be in a dialysis center or to have a dialysis machine.

Kidney transplantation is a very attractive option for renal replacement therapy because no dialysis is needed.A kidney transplant can come from a family member, a person who is not a blood relative like a spouse or a friend, or from a donor who has died.

Most patients need to be treated with some form of dialysis before a kidney transplant can be accomplished.Sometimes a transplant is done before dialysis is needed.

Kidney transplant patients must take immunosuppressive medication to prevent rejection of the kidney transplant for as long as the transplant is working.

Many patients start on hemodialysis as an initial therapy. As they become more knowledgeable, they may switch to peritoneal dialysis when they feel capable of performing their own dialysis treatments.

Some patients learn to per form home hemodialysis that also requires special training.

Many patients on dialysis plan to receive a kidney transplant.Transplant recipients facing loss of their transplant from rejection can choose to return to hemodialysis or peritoneal dialysis.It is very likely that patients with kidney failure will be treated with more than one kind of treatment modality during their lifetime. The choice of the initial therapy is less important than we tend to think.

If we are unhappy with our choice or experience difficulties with one therapy,we can change to another renal replacement therapy.

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