Lesson 4 - Choices for treating kidney failure (The Basics)

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Lesson Objectives

By the end of each session, participants will be able to:

Identify the four treatment choices for kidney failure.
State how hemodialysis and peritoneal dialysis differ in frequency of treatment.

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Session Starter:

There is a lot to know about the different treatments for kidney failure. What questions do you have? (Or ask what they have seen in their own community. Do they know people on dialysis? What have they heard about it?)

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Topics & Points To Cover:

You have treatment choices, and you can change your mind.
No renal replacement therapy also known as conservative management
- Active medical care without RRT
- Palliative care when necessary
- Complications can be managed, but can’t compensate for uremia
- End of life choices – living will – telling family
- Can change your mind
Hemodialysis(HD)
- Two types
  - In-center (most common)
  - Home hemo: treatments are done at home, requires assistance, you have more control, can be harder on the helpers.
- How it works
- PROs and CONs
  - The diet (in-center is most restrictive, only 3 times /wk, build up between treatments)
  - Lifestyle: social aspects
  - Safety/infection
Peritoneal dialysis (PD)
- Two types
  - Continuous ambulatory PD
  - Continuous cycling PD
- How it works
- PROs and CONs
  - Storage space for supplies (delivered monthly)
  - Diet (blood is cleaned every day, diet is less restrictive)
  - Safety/infection control
Kidney transplant
- Types
  - Cadaveric or living donor
- Eligibility
- Transplant evaluation
- Waiting list
- Still MUST take medications including anti-rejection medications
- PROs and CONs
  - The diet (least restrictive)
Cultural aspects of different choices
- Be sensitive to your target audiences cultural beliefs in regards to all of the available options