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What are the relative pros and cons of haemodialysis and CAPD?

Q: My mother is 82 years old and is suffering from chronic renal failure. Initially, for about a week the doctors tried to give drip under diet control and some medicines to bring down the creatinine value from 7.5 to 6.2 but found it going up again to 8. The urea level also went up from 140 to 156. Thereafter, a nephrologist was consulted who recommended dialysis. My mother is covered by medical scheme and hence money is not a constraint. The question is whether haemodialysis is painful to the patient? We brothers feel that if it is painful for her, she could go through CAPD. I feel that haemodialysis could not be painful as it is done under the doctor's supervision and if it is painful then a suitable anaesthesia would be administered to relieve the patient of any pain during the dialysis but we don't know if it pains after the dialysis. Can you tell us which of the two is preferable, when cost is not a criterion? The second question is whether I (aged 63) can donate my kidney to her and what are the chances of recovery for her and risks for me?

A:Haemodialysis is not a painful procedure except the putting in a venous catheter for haemodialysis access, which is inserted under local anaesthesia, which may cause pain at the time of insertion. The dialysis procedure in itself is not painful. Your nephrologist can guide you better about your mother's suitability for the type of dialysis. Both forms of dialysis are good. The peritoneal dialysis is done at home by the patient or the close kith and kin who are trained. If there is clean environment at home and sterility and cleanliness of the procedure is observed then CAPD is a good procedure provided there are no contraindications, like abdominal surgeries, hernias and backache. Each session requires about 45 minutes 4 times a day, everyday. Haemodialysis is done in a dialysis centre, 4 hrs, three times a week. There is chance of cross - infections like hepatitis C & B in haemodialysis to CAPD or vice versa. Your mother's age is such that she should not consider transplantation as an option.


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