My Dad on Peritoneal Dialysis

Convinced that peritoneal dialysis would be the best dialysis treatment for my dad, my aunt, a physician based in Bataan, ordered my dad to go to Bataan so that the insertion of the peritoneal catheter on his abdomen can be performed already.

She wanted it bo be done in Bataan so she could monitor his condition.

My father's peritoneal catheter insertion was just timely because he needed to have a dialysis immedietely since his creatinine level was on a very high of 12.

I followed my father to Bataan the following day so I can be trained to do the peritoneal dialysis at our house.

It was a tedious process. I have to infuse his abdomen through the opening in his catheter 500 ml of liquid solution called the dialysate after six hours all the wastes that accumulate through the infused liquid should be drained out .

The drained liquid should be measured and it should be equal to 500 ml.After draining all the solution, a fresh solution will be infused again. The same procedure is done every six hours, four times a day.

I have to perform my father's peritoneal dialysis at 6am, 12nn, 6 pm and 12 am. The whole procedure last for an hour.

While I was doing my father's peritoneal dialysis, I know that it is something we have to do for the rest of his life, so at that time I was contemplating on quitting my job to become his full time caregiver.

My aunt got information from my father's nephrologist that their is a machine called the cycler that is available to perform my father's peritoneal dialysis. It is program to do the dialysis at night while my father is sleeping. My aunt told me that it would be best that before my father goes home to Quezon City that machine is at our house already.

I went home while my father was left in the house of my uncle, my father's brother. My uncle, who is a nurse will do the peritoneal dialysis on my father. My aunt cannot do it for my dad because she is very busy attending to her many patients.

As soon as I reached Quezon City, I immedietely contact the pharmaceutical company that distribute the cycler. The machine can be used for free provided that the dialysate and other solution used for peritoneal dialysis will be bought from them. The pharmaceutical company was expecting my call because my father's nephrologist informed them beforehand about our interest in availing the machine.

I was too shock to learned from the pharmaceutical representative that a month's supply of the dialysate will cost P45,000 a month. Clearly, that amount is something we cannot afford even if my aunt will be helping us with the expense.

We have no choice but to transfer my father from peritoneal dialysis to hemodialysis.

After trying continuous ambulatory peritoneal dialysis we've discovered that:

1. Although the procedure can be done at the comfort of our own house by a trained family member, it is really expensive compared to hemodialysis.

2. It is a tedious process. It takes an hour to finish and it has to be performed four times a day. There are some instances wherein patients on peritoneal dialysis should be drained six times a day.

3. There is a high risk of developing infection. There could be a leak in the catheter, an opening in the catheter can be a way for bacteria to get into the body.

4. My father was uncomfortable with the whole procedure . He feels his carrying an extra weight on his abdomen due to the 500 ml infused in his body.

The above stated information is based on our personal observation and this is not written to discourage the use of peritoneal dialysis. There are some instances that there are some people with whom hemodialysis is not the suitable type of dialysis for them.

How He Was Diagnosed with an End Stage Renal Disease

In November 2006, my family met up with my aunt's family to visit our dead loved ones for the All Saints' Day.

My aunt, a physician, noted that my father was losing a lot of weight. She told my father to go to her clinic so she could do some work-up with my father to determine what was the reason behind his rapid weight loss.

Maybe it was because I often see my father that I wasn't able to note the physical changes happening in him. I asked him if he feels sick, he just told me that he doesn't have appetite for food, he feels tired and he find it difficult to breath at a times.

There were times in the past months that he would have swollen feet but we dismissed it thinking that it was his rheumatism.

The results of the lab test show that he has an elevated creatinine, high level of blood urea nitrogen, and his red blood cell count is below normal.

My aunt referred my dad to a nephrologist- a specialist on kidney disorder. The nephrologist gave my dad medications for his hypertension which was just diagnosed , an erythropoietin injection to normalize his blood count and other medicines. He was then ordered to return to the clinic after a week with the results of a new set of laboratory exams ordered for my dad.

On his next visit to his doctor, the nephrologist noted that there where no change in the laboratory results and that the creatinine level got more elevated. He then ordered a nuclear glomerulus filtration rate test or a nuclear gfr for my father.

We had his nuclear gfr taken at the National Kidney Institute and Transplant Institute.

My dad called me in the office and informed that according to the test, only 8 percent of his kidneys were functioning and that he needed to have a dialysis the soonest time possible because his creatinine level is now at seven when the normal level should be below 1.3.

His kidneys were damaged as a complication of his hypertension. Since only 8 percent of his kidneys were functioning and that the condition is irreversible; he is now suffering from an end stage renal disease.