Q: I am a 70-year-old female just starting peritoneal dialysis. I have high blood pressure controlled with medication, no diabetes. What can you tell me about life expectancy?
A: Healthy kidneys clean our blood by removing waste, excess fluid and minerals. When the kidneys fail, blood pressure may rise, the body may retain excess fluid, fail to produce a sufficient amount of red blood cells, and harmful waste builds up within the body. Thus, dialysis becomes available to take over for what the failing kidneys can no longer do. There are two methods – hemodialysis and peritoneal dialysis. With hemodialysis, blood is pumped out of the body to an artificial kidney machine and then it is returned to the body via tubes. With peritoneal dialysis (PD), a catheter fills the abdomen with a cleansing liquid. The solution contains dextrose, a sugar that will pull waste and extra fluids into the abdominal cavity. When the dialysis solution is drained, the wastes and fluids are removed from the body and discarded. The process of exchange from filling to draining takes about a half hour and is typically done four times a day. One form of PD known as continuous ambulatory PD (CAPD) is accomplished without requiring a machine. A patient can walk around and function as he or she chooses. Another form of cleansing is referred to as continuous cycle-assisted PD (CCPD) that requires a machine to fill and drain the abdomen. Despite the form chosen, a soft catheter will be placed in the abdomen. The catheter will be placed in position by a physician who will make a small incision most commonly below the navel.
The PD process has been utilized since the 1980s. Because of advances in research, the side effects today are substantially reduced from what they were initially, as is the case with many diseases. Infection is high on the list for people on PD. A patient should follow the instruction of his or her health care team to avoid problems and should advise his or her physician if fever, redness around the catheter, vomiting, cloudiness of the dialysis solution and other changes occur.
I cannot provide you with a prognosis because I don’t know how far along your kidney failure. What I can indicate is that most individuals who require dialysis of any kind do face serious health issues, some that affect the kidneys; however, thanks to dialysis, life is prolonged for many of them who can continue to enjoy a good life that is somewhat shorter than that of the general population. End stage renal failure progresses until the organs can no longer function and uremia sets in, which is characterized by weakness, bad breath, edema, chest and bone pain, diarrhea, and other unwanted symptoms. You have the capability of improving your overall health by eating well, choosing foods low in sodium and phosphorous, taking your medication at the appropriate time, and following your health care provider’s recommendations. Good luck.
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