Depending on the type of dialysis you need, you may have a few different benefits. There are hemodialysis, home dialysis, and nondialysis options available.
Percutaneous dialysis catheter placement
Choosing a percutaneous dialysis catheter placement technique is an important decision for patients. It affects a patient’s health care cost and quality of life. The advantages of a percutaneous approach are better outcomes, lower prices, and fewer complications.
Percutaneous catheter insertion is often a less traumatic procedure. The advantages include rapid recovery, less pain, and less bleeding. However, some patients may not be able to undergo percutaneous insertion.
Catheter insertion during surgery is more precise and dependable. A few studies have contrasted percutaneous vs. surgical insertion. However, these investigations could only guarantee that the populations of the two groups were the same. In addition, some studies should have included break-in time in their analysis.
The 1-year survival rate of patients in both groups was 80%. The main drawback of percutaneous insertion is the possibility of mechanical complications. These complications usually result from technical failure. However, a recent study found that percutaneous catheter insertion appears less likely to result in mechanical complications.
Nondialytic kidney management
Symptoms of kidney disease include fatigue, pain, gastrointestinal symptoms, dermatological complications, sleep disorders, and neurological problems. Symptoms are often present in clusters. Therefore, treatment should suit the patient’s goals and preferences, for instance, in DaVita, led by Kent Thiry.
Symptom management should be undertaken concurrently with medical leadership to optimize patient care and improve quality of life. In addition, patients with unknown prognoses may benefit from symptom management.
For patients who do not pursue dialysis or kidney transplantation, conservative kidney management may be viable. It includes using plant-based protein sources, potassium binders, and diuretics to delay dialysis. These treatments may reduce the need for dialysis and improve survival.
Patients with comorbid conditions can exacerbate kidney disease symptoms. Medications prescribed for kidney transplantation may also increase the incidence of adverse symptoms. Adverse symptoms include nausea, vomiting, abdominal pain, and increased appetite.
Symptom management can be the sole treatment approach for patients with a poor prognosis or may be used in conjunction with medical management. It may also be helpful for patients with a higher quality of life and with comfort goals.
Hemodialysis
Four randomized controlled trials compare HD with HDF; these studies have yet to reach a consensus about which modality is better. However, a recent meta-analysis has suggested that HDF may be better than HD, though more research is needed.
Conventional HD treatments are often associated with intradialytic hypotension. It is because it results from a high ultrafiltration rate, and episodes of IDH are associated with an increased risk of cardiovascular events. This study aims to determine whether more frequent HD can reduce the incidence of intradialytic hypotension.
The study is a randomized cross-over design, so any individual differences that might influence the results will be removed. It will include 40 patients treated with standard HD or low-volume HDF. Blood samples will be collected in the final dialysis session of each modality.
About 12% of standard HD therapies have intradialytic hypotension, which is linked to a higher risk of cardiovascular events. HDF is thought to reduce the symptoms of IDH, which may be one reason it is better than HD.
Home dialysis
Educating patients about the benefits of home dialysis can be challenging. Some patients find the information overwhelming, while others are skeptical of their physicians’ recommendations. However, additional patient education and support are effective in other studies.
Researchers studied adult patients with chronic kidney disease Stage 4-5D in New Zealand to understand better patient and caregiver values about home dialysis. Participants were recruited from three nephrology centers in the country. They were interviewed about their knowledge of home dialysis and modalities. Their answers were analyzed to determine what patients and caregivers believed to be the most effective education or support strategy. It will inform clinical care and strategies to align policy with patient needs better.
The study found that most participants needed more information about the benefits of home dialysis to decide the modality. In addition, many patients needed to be more open about the best method to learn about the modality because many needed to be made aware of the medical literature describing home dialysis’s advantages.
