Welcome to Dialysis in India!
(Disclaimer: All information on this website is purely for informational purposes. Please consult your doctor before making any changes to your treatment, diet or lifestyle. The author of this website is not responsible for any consequences of acting on any information published on this website.)
Being diagnosed with kidney disease can be quite unnerving. Having to get on dialysis, even more so. There is a lot of information about kidney disease and dialysis on the internet. However, there are many things about kidney disease and dialysis that are different in India from the rest of the world.
This site will try to give information and support to the dialysis community in India. Please email us at email@example.com if you have any questions or comments.
When you are diagnosed with kidney failure, you need some sort of renal replacement therapy - some sort of therapy that replaces your kidney function. There are plenty of options. Here is a list of the different options with possible advantages and disadvantages:
1. Kidney Transplant: Top there is the indisputable king, a renal transplant. Despite all the risks, the costs, the possible complications, a kidney transplant continues to offer the best outcomes. For many, the most important benefits of a transplant are the freedom from dialysis and the freedom from fluid restrictions. Despite all what people say about daily nocturnal offering outcomes equivalent to cadaveric transplants, dialysis and its attendant problems, both physical and mental, can be overwhelming. Many would take a transplant any day.
Some would go so far to say that once you are diagnosed with kidney failure and are going to need some form of replacement 'soon', do all you can to get a transplant without having to get on to dialysis at all. Try not to know fluid restrictions at all. This is possible and is happening quite often these days. All it needs is swift, prompt, proactive action.
2. CCPD: Second would be Peritoneal Dialysis connected to a cycler at night. This would free up your days and give you the benefits of minimal fluid and diet restrictions. With portable cyclers already available, travel would also not be an issue.
3. CAPD: Third would be manual Peritoneal Dialysis. Three to four exchanges every day. This offers the advantages of minimal diet and fluid restrictions. The only hassle being the 30-35 minutes three to four times a day that you need to spend on the exchanges. Travel is also possible because most providers nowadays have the facility of supplying bags wherever you go. Ideally the patient should self-administer the exchanges to realize the true flexibility and independence of PD.
4. Daily nocturnal home hemodialysis: The best hemodialysis modality. 7 to 8 hours, 6 to 7 nights a week. The problem is you still need to suffer the needles. There is also a certain element of risk. Blood leaks can happen. Hypotension and cramps can happen. Despite all this, the benefits far outweigh the risks. The full advantage of the modality can be realized only if you self-dialyze. It is difficult but can be achieved with proper training available in some countries (not in mine).
5. Short daily home hemodialysis: Two to three hours everyday at home. The problem with this is the fluid removal rates can still be high. Fluid restrictions will still apply. Risks are reduced because you are most likely awake.
6. In center nocturnal hemodialysis: 4 to 6 times a week, 7 to 8 hours in center. Offers the benefits of longer duration dialysis but you need to go in-center. Cross infections, inflexibilities.
7. Twice/Thrice a week home hemodialysis: Regular hemodialysis except that its at home. The problems of the modality remain. However at least you are saved from the danger of cross infections with viruses such as Hepatitis B, C and HIV.
8. Regular, in-center hemodialysis: Regular hemodialysis in a center. The least favored option. The default for most people. The only option most people are told about.