Doesn't sound too appealing to me but maybe I should consider it. Sucks having to drive there three times a week.
It's definitley not a silver bullet, and you're right; it is more time intensive.
The poster's original point was that hemodialysis is not a static existence that can last indefinitely-- there are definite long-term side-effects that will most likely do you in. ...before you receive a transplant.
My only point was that, comparitively, P.D. is a more homeostatic option.
Another poster mentioned a different set of side-effects, though. I'd like to hear some feedback from her as well. Especially if it's something we haven't taken into account yet, but might end up seeing with my grandfather.
I'll be praying for you and your family as well. Dialysis sucks, regardless of the route taken. Beats the alternative, though.
Hemo (HD): In the USA, with three (instead of UK/European four) treatments a week, the fluid "swings" are much bigger, thereby increasing the need for a "harder pull" at the HD unit because of fluid buildup between treatments; that puts a strain on the heart (esp. in the elderly) and the peripheral circulation (we concluded leads to the amputations we were seeing -- even of fingertips in small women...)...as well as the kidneys themselves from dehydration (further decreasing residual function, RRF). The most "successful" younger patient we're aware of has to fib to the technicians at the unit to keep them from pulling him too hard: he is doing well on his residual renal function, fluid swings, weights and blood pressures even with a failed kidney transplant (with pancreatic tissue transplant) by using a careful supplement program (some of which defies what the medical experts say), including material he has learned from the book Sugars That Heal. Another issue is the way your AV shunt gets treated by any given technician; they're expensive ($30k each), damaged easily and you can run out of sites. They become kind of ugly and gnarled after a while, as well. BTW, an AV shunt is an anastomosis between an artery and a vein in your forearm -- kind of unnatural, and certainly more so than a tube coming from your intraperitoneal space. AND preventing systemic infections are under YOUR direct control when you are on home PD. And let's not forget sudden cardiac arrest in the chair (we saw plenty of those in only five months) and aluminum contamination of your system from the dialysate. Best of all, the constant tug-of-war with an ignorant tech who would rather put saline solution back into your system AFTER pulling you too hard: that makes sense...
PD: Your protein allowance is not only generous, but can be problematic (esp. for the elderly) to keep on top of; too many infections too close together can jeopardize your longevity on PD (but YOU have the control); night-cycling alarms can make for loss of sleep (but for younger people this should not be a problem: you simply learn how to avoid them); the time commitment is greater but you have more flexibility in your schedule. The BIGGEST benefit we have found is keeping control of your situation instead of trusting undertrained, obnoxious, haughty techs who sometimes don't even speak your language in units that in the past have hired junkies right off the streets (an infamous scandal that has been since addressed). I could go on and on in that vein and will privately if requested. In short, you take almost full control of optimizing all aspects of your medical picture based on your labs and kinetics testing instead of giving over control blindly to a stupid tech who has more pull with the doctor and the system at any given critical point than you do. And if your blood pressure should get too high between treatments (on HD), for whatever reason, well, that's no biggie: you will likely just have to wait it out until the next scheduled session. Don't you love it?
Perhaps best of all with PD: the docs and the system make less money all the way around. Let's hear it for that one!!! (We don't call them vampires in this household for nothing.) We DO like our doc, a young woman who is open to working with us on our approach to various issues that can't be ignored but respond better to some alternative approaches than otherwise.