Treatment Choices - End Stage Renal Disease (ESRD) National Coordinating Center (NCC)

STARTING TREATMENT TREATMENT CHOICES LIVING WITH DIALYSIS COMMUNITY EDUCATIONAL MATERIALS

Do you know about the treatment choices that may be available to you and what to plan for? This section can help you explore treatment options that you can then discuss with your kidney care team.

Know Your Choices

There are several treatment choices for you to think about. Whether you are new to dialysis or it has been your treatment choice for some time, you can always ask about changing to another type of dialysis or talk with your kidney care team about a kidney transplant. Click on the links below to learn more about your treatment choices.

Treatment Choices Overview

“Kidney Failure: What are my treatment choices?” provides an overview of your treatment choices.
“Consider Your Dialysis Choices: Choosing the right option for you! (Updated 06/2016)” helps you to learn more about your dialysis options so that you can choose the treatment that is best for you.
“Know the Facts About Home Dialysis Choices” provides information about your choices for home therapy and important things to consider.

Kidney Transplant

A kidney transplant is a surgery in which a person with kidney failure receives a new kidney. The new kidney takes over the work of cleaning the blood. The new kidney comes from another person. Only one kidney is transplanted. A person can live a healthy life with only one working kidney. A kidney transplant is a treatment option. It may free you from having to do dialysis, but it is not a total cure for kidney failure. Your kidney care team will also talk with you about the different medications that you will need to take after receiving a kidney transplant.

When you find out your kidneys are failing, you may wonder if a kidney transplant is right for you. Read “Get the Facts: Kidney Transplantation“, to learn more about this treatment choice.
Browse through “Your Life Your Choice: Transplant Stories“ This booklet contains real-life stories of kidney transplant recipients and donors, as told in their own words. The stories were created as a way to share positive perspectives on kidney transplant as a treatment choice. The booklet does not provide medical advice or information, but rather a first-hand narrative from the patient’s perspective.
“Is a Kidney Transplant Right for Me? Your Guide to the Transplant Process“, takes you step by step through what is involved in getting a kidney transplant. It provides answers to questions about being evaluated for transplant, the transplant team, the surgery, what happens after surgery, and more.

Hemodialysis

Hemodialysis (HD): Hemodialysis is a treatment that is used to remove excess fluid and waste products when your kidneys have stopped working. To do this treatment a special access to your blood supply will need to be created; this is called a vascular access. This is a place where blood can be drawn from your body, run through a machine that has a filter to clean your blood and remove the extra fluid, and then returned to your body. You will need hemodialysis at least three times each week to clean your blood. You can do hemodialysis in a clinic or at home.

Hemodialysis cleans your blood through a vascular access which can be a fistula, graft or catheter. If you have kidney failure, one of these will be your LIFELINE to treatment! Click here to learn more about the three different types of lifelines, and talk with your doctor to decide which is best for you.
If you and your care team decide that hemodialysis is the best choice for you, you may want to use this “Be Prepared Hemodialysis Checklist,” to help you take an active role in having safe treatments.
If you and your care team choose a fistula as your access type, there are simple Do’s and Don’ts of how to keep your lifeline healthy. Click here to learn how!

Peritoneal Dialysis

Peritoneal dialysis (PD): Peritoneal dialysis is another treatment option to consider. PD is usually done at home. To have PD treatments, a tube is placed in your abdomen. The tube is used to run a bag of fluid into your abdomen. This can be done using a machine called a cycler, or by hand. If you are doing PD by hand, you can leave fluids in your belly by capping the tube. As you go about your day, the waste products and extra fluid you need to get rid of will leave your blood vessels and go into the fluid that is in your belly. You can then drain the fluid out, and repeat the process again, so that you are cleaning your blood throughout the day.

Home Dialysis

Having your dialysis treatments at home may be an option for you to think about and discuss with your care team. Click here to watch a video of patients sharing how home dialysis has improved their lives.

‘My Life, My Dialysis Choice’ Decision Tool

If you are considering different treatment choices, the “My Life, My Dialysis Choice” decision tool can help you to decide which treatment choice may be right for you to discuss with your care team, based on what matters most to you. Click here to take this interactive test.

Who will need a Vascular Access?

If you and your kidney care team decide that hemodialysis is the best choice for you, you will need to have a vascular access created. This is important because an access is your lifeline for a lifetime. Click on the links below to learn more about getting a vascular access.

Access Planning Manual

In order to get started with a vascular access, you will need an access plan to help guide you through the steps. The Access Planning Guide can help you and your kidney care team make this plan together. An online interactive guide is available by clicking here. The guide is also available for download in English and Spanish.
English | Spanish

Questions or Concerns about a Permanent Access? Let’s Talk!

It’s normal to have questions or concerns about your access. Talking with your kidney care team about what’s on your mind is the best way to overcome any challenges you may be facing. Click here to review some of the common access questions and concerns that you can discuss with your kidney care team.

Fistula Maturity and Graft Healing

“Ready, Set, Go!” Learn more about the steps to catheter freedom and how to check your new Fistula or Graft everyday.

Fistula Maturity

Weeks 1-2: New Fistula Daily Check
Week 3: New Fistula Daily Check
Weeks 4-5: New Fistula Daily Check
Weeks 6-10: New Fistula Daily Check

Graft Healing

Week 1: New Graft Daily Check

Weeks 2-3: New Graft Daily Check

Week 4: New Graft Daily Check

Access Monitoring

Once you have a vascular access, it is important to check it every day. You can learn how to do your daily One Minute Access Check in this online video. The Access Monitoring Guide can also help you learn the three simple steps to check your access daily. An online interactive guide is available by clicking here. The guide is also available for download in English and Spanish.
English| Spanish

Catheter Check

A hemodialysis catheter is the “bridge” to a long term access — a fistula or a graft. If you have a hemodialysis catheter, it is important that you check it everyday. You can learn how to do your daily One Minute Catheter Check in this online video. You can also download the One Minute Catheter Check by clicking here.

Living with Dialysis

Having a voice and playing an active role in your care is important. Click here to learn more about living with dialysis and how you can get involved in your care!