The Best Part about Peritoneal Dialysis is that it is Continuous
Originally posted here on April 17, 2022.
Yesterday evening, I went to an uncle's 75th birthday party. When I came back home, I checked my weight. I was surprised that I had gained about 2.7 kgs in a day. Saturdays are my nights off hemodialysis. So I try keep my fluid weight gain below 2 kg. I rarely succeed. Saturdays are holidays and on holidays, I always drink more water. The summer heat of Hyderabad didn't help and yesterday, I craved a Fresh Lime Soda in the evening. So pulled out my Mr. Butler's Soda maker and helped myself to a small glass.
While it is not going to be too much of a problem as I will get dialysis tonight and should be able to pull off the balance fluid over the next three nights, for a second, I wished I was on Peritoneal Dialysis (PD).
Why? How would it be any different?
PD is a continuous therapy. It is happening all the time. The fluid in the peritoneal cavity is filtering out excess water from the blood continuously.
So, in yesterday's situation, what would have happened if I were on PD? I would have done my night exchange just before going to bed and the excess fluid would have started getting pulled out almost instantaneously.
Why couldn't I do a hemodialysis session last night, then?
For the simple reason that you can't just get onto HD with the same ease as with PD. Even if you don't rely on a technician (which I do), the setup of the machine and the whole process of getting onto dialysis takes about half an hour at least. Also, cannulation. Not very pleasant.
The resistance to do a session of HD is much more than the resistance, if any, to do a PD exchange. Even if you're using a cycler and doing Automated PD, the setup is much simpler than HD. Also, no cannulation. Very pleasant.
Well, regular readers of this blog know I have always been a huge fan of PD and never miss an opportunity to extoll its benefits. There are downsides as well, like with everything in life. It works better when there is some residual kidney function, the peritoneal membrane doesn't usually last forever and so on. All those reasons still do not explain the abysmally low PD numbers around the world. That continues to be my pet peeve with the Nephrology community, of which I am now a part. Even today.