When anyone in my extended circle of family and friends or their extended circles is diagnosed with kidney disease, they reach out to me. Having lived with this disease for the last almost 24 years, and having managed not too badly, people feel I could advise them about how to get going on this arduous journey.
One thing is common among almost all these people. They have not heard about Peritoneal Dialysis (PD). They do not know what it is. They have no clue that such a thing exists.
It is unfortunate that even after all these years, PD continues to be the bastard child of nephrology.
I have often thought hard about this. I have discussed with many people. Why is PD relegated to the fringes even today? Is it physician training? Physician reimbursement? Patient reluctance? Manufacturers' reticence? A combination of all these?
I have never got a convincing answer.
Today, after all these years, if I had a choice to choose a dialysis modality with no clinical constraints, I would pick PD with no hesitation.
And yet, there are thousands of newly diagnosed patients who are being put on Hemodialysis without being given a choice, without as much as being told about the option.
An option where there are no needles;
An option where you can don't need to go to the hospital;
An option where you have complete control over your therapy rather than relying on dialysis centre staff;
An option where your residual kidney function is preserved better than in Hemodialysis;
An option where you are not at risk of contracting infections like Hepatitis C because of exposure of your blood.
What's not to like?
Well, granted that some people don't like to have a tube in their stomachs. Some people don't like taking care in their hands. Bringing dialysis home is also not suitable for some. There also is an increased risk of bacterial infections. Agreed. There are some negatives.
However, is it too much to ask that I at least be told about all the options? Options that will affect me and could be life changing.
At NephroPlus too, we have tried multiple times to introduce PD for our guests. It just didn't work out. I do not know why. We were ready to invest heavily. We were ready to take losses in the beginning. Nope! It just wouldn't work.
Where does that leave us? Is PD doomed to be a therapy only for those for whom Hemodialysis is not an option?
I believe patients need to be more aware. When someone is diagnosed with Kidney Failure, they need to find out everything that can about it. Find out what the options are. Read up on what the prognosis is. Think about what you would like. Think about which option would work for you best. Then have an informed discussion with your doctor. And together, decide what's best for you.
YOU are the affected party. YOU must have a say. Anything less than that is foolish on YOUR part.