MO-10-12-CKDThis material was prepared by Primaris, the Medicare Quality Improvement Organization for Missouri, under contract with the Centers for Medicare & Medicaid

Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy

Chronic Kidney DiseaseTreatment Options

Learning about options will better assist you in making the best decision that suits your health and lifestyle.

Why discuss options?

Why discuss options?Not every treatment option will work for every person and there are many factors that determine which option is best.

Discussing pros and cons is helpful.

Why now?Patients are educated on their options usually when their kidney function is around 15%.

Peritoneal Dialysis

Hemodialysis

– In dialysis unit

– Home

Kidney Transplantation

What are my options?

What do kidneys do?Healthy kidneys clean your blood by removing excess fluid, minerals, and wastes.

Also make hormones that keep your bones strong and your blood healthy.

What happens when they fail?

Harmful wastes build up in the body, blood pressure may rise, and you may retain excess fluid and not make enough red blood cells.

Dialysis is then needed.

What is Dialysis?A treatment that filters the blood of wastes and extra fluid when the kidneys are no longer able to perform this function using a semipermeable membrane (filter).

Type of DialysisPeritoneal Dialysis filter inside the body

Hemodialysis filter outside the body

Peritoneal DialysisUses a space inside your belly called peritoneum as a filter to clear wastes and extra fluid from your blood.

You will need to have a catheter placed in your belly before you begin dialysis.

ExchangeThe process of doing peritoneal dialysis is called an exchange.

You will usually complete 4 to 6 exchanges each day.

How does it work?Fill: Dialysis fluid enters your peritoneal cavity.

Dwell: While the fluid is in your peritoneal cavity, extra fluid and waste travel across the peritoneal membrane into the dialysis fluid.

Drain: After a few hours, the dialysis fluid is drained and replaced with new fluid.

Example of Exchange

National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov

Types of Peritoneal Dialysis

CAPD

– Continuous Ambulatory Peritoneal Dialysis

CCPD

– Continuous Cycling Peritoneal Dialysis

CAPDHappens during the day as the person goes about their daily life at home, work, or while traveling.

Normally four exchanges usually morning, lunch, dinner and at bedtime.

An exchange takes about 30 - 40 minutes.

The solution is left in the peritoneal cavity between exchanges and overnight.

CAPD

National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov

CCPDThe dialysate solution is changed by a machine, at night for 8 to 10 hours, while you are asleep.

In the morning, clean solution is left in the peritoneal cavity during the day.

CCPD

National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov

HemodialysisProcedure that allows blood to flow through a machine and enter an artificial filter called the "dialyzer" to remove wastes and excess water from body and let clean blood flow back to the patient.

HemodialysisYou will need to have dialysis access placed prior in your arm or neck before starting treatment.

It is normally done in an outpatient dialysis unit three times per week for 3-4 hours each session.

National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov

Home HemodialysisHemodialysis can be done at home either during the day or at night.

A machine is placed in your home and you and a partner are trained to learn how to do the procedure.

It is normally done 5 - 6 days/nights a week.

TransplantationA kidney transplant places a healthy kidney from another person into your body.

– Transplants can come from living or non-living (cadaveric) donors.

TransplantationThe new kidney is placed in your lower abdomen.

– Most people need to be hospitalized for 1-2 weeks after their transplant.

A successful transplant can help return you to a state of good health.

TransplantationTransplant is a treatment, not a cure.

– Will need to take medicine and see a doctor regularly.

You may need to wait for a kidney to be available.

– A donor kidney must be a “match” for your body.

– Complete medical evaluation to determine if you are a transplant candidate