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My Treatment and Why I Chose It

Ivan Rivera is a 22-year-old living in Orlando, Fla., who had been an active and athletic person all of his life. But when he started losing energy and tiring easily, his doctor told him his kidneys were failing due to a rare immune disorder called IgA nephropathy. Ivan was devastated by the news. He tried in-center hemodialysis, but was having trouble maintaining his normal, active lifestyle. His home dialysis nurse, Debbie Thompson, introduced him to peritoneal dialysis (PD), and Ivan’s life turned around.

To administer his PD treatments, which are done at home, Ivan chose an automated peritoneal dialysis (APD) therapy. In PD, a concentrated dialysis solution is infused into the peritoneal cavity, which is the space under the abdominal muscles and outside the organs. PD takes place through the peritoneal membrane that surrounds the abdominal organs. The peritoneal membrane filters the body’s waste products and excess fluid out of the blood as it naturally works to dilute the concentrated dialysis solution. The PD machine is easy and safe enough for patients to operate independently and without a care partner, so Ivan can now administer his own treatments and dialyze overnight while he sleeps. The machine is small enough that it sits on Ivan’s nightstand, and it is also available with a cart that makes it easy to move it around the house.

Ivan started on PD in September 2008, and today he says his life is back to normal. He is going to the gym and spending more time with his family, and is also planning a vacation to Puerto Rico to visit his homeland. Since his PD machine is less than 30 pounds, it can easily be taken along on trips using the custom travel stroller, which gives him freedom to go wherever he wants.

“When I was introduced to peritoneal dialysis, it was a whole new world,” said Rivera. “It was so much easier and better for me than going to the clinic. Now I can go to work and school during the day, and sometimes I don’t even feel like I’m doing a treatment. It’s my lifesaver.”

Juan Gonzalez, a 50-year-old St. Cloud, Fla., resident, has been fighting kidney disease since he was a child, and in 1981 his kidneys failed. In the beginning, he was going back and forth from the clinic for in-center hemodialysis. After three years of this routine, he received a transplant from his brother that was successful for 12 years, but due to complications he had to go back on dialysis.

After returning to in-center treatment, Juan decided to try home hemodialysis with the encouragement of his dialysis care team and the support of his wife. Since hemodialysis at home requires a care partner, Juan’s wife helps administer his treatment. Juan has a point in his arm called a vascular access, where two needles allow his blood to flow to and from an artificial kidney, and then back into his body. The treatments can be administered on Juan’s schedule, and to make the experience as comfortable as possible, he and his wife have designed a special room in their home dedicated to his care, with bright colors and family photos on the wall.

As a result of his transition to home treatment, Juan has more energy and time to spend with his wife — in the garden, out shopping, or exercising to improve his health — and he’s more at ease with his condition.

“I love doing my dialysis at home and I feel better. Sometimes I forget I’m a dialysis patient because I feel like I’ve gone back to a normal life,” Gonzalez said. “The nurses trained me and my wife to make sure we were prepared, and the machine does everything step by step, so it’s easy to do.”

Patients should consult with their doctors and dialysis care team to see if home dialysis is right for them, because there are more and more people like Ivan and Juan who have made the change with great success. Home treatments empower patients by giving them health benefits as well as more flexibility in scheduling treatments, and more freedom to live the lifestyle they choose every day.

Debra Thompson, RN, is Manager of Home Therapies for Fresenius Medical Care North America.

This article originally appeared in the November 2009 issue of At Home with AAKP.