Transcript Chronic Kidney Disease Treatment

Chronic Kidney Disease
Treatment Options
MO-10-12-CKD
This 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
Why discuss options?
Learning about options will better assist
you in making the best decision that
suits your health and lifestyle.
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%.
What are my options?
Peritoneal Dialysis
Hemodialysis
–
In dialysis unit
–
Home
Kidney Transplantation
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 Dialysis
Peritoneal Dialysis  filter inside the body
Hemodialysis  filter outside the body
Peritoneal Dialysis
Uses 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.
Exchange
The 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
CAPD
Happens 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
CCPD
The 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
Hemodialysis
Procedure 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.
Hemodialysis
You 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 Hemodialysis
Hemodialysis 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.
Transplantation
A kidney transplant places a healthy kidney
from another person into your body.
–
Transplants can come from living or non-living
(cadaveric) donors.
Transplantation
The 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.
Transplantation
Transplant 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.
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A donor kidney must be a “match” for your body.
–
Complete medical evaluation to determine if you are a
transplant candidate