By Alejandro Lopez de Haro
Bad experiences with a particular treatment for kidney disease in Latin America has led some patients in the United States to limit their options.
Jaime Juarez, 46, is feeling a lot better. For several months he was feeling tired and dizzy because of his chronic kidney disease (CKD), which causes the functionality of his kidneys to decline at a faster rate than average. Now after having spent close to a month undergoing dialysis treatment at Satellite Dialysis Center in South Gate he is feeling a lot of better.
“I had no energy three weeks ago,” said Juarez, who had to stop working because of his condition, but will soon return within the month. “Now I feel great.”
Dialysis treatment is a procedure that cleans toxins and excessive water from the blood of patients. A person’s body needs this to function and live. Patients with kidney disease usually do this while they wait for a kidney transplant.
Juarez opted for a flexible type of procedure referred to as peritoneal dialysis. This is a treatment that makes use of his own peritoneum, a membrane in the abdomen, to filter the toxins out of a person’s body, essentially acting like a kidney.
The patients can do this themselves throughout the day, by simply setting a time aside four times a day, to infuse and drain their body with special solution through a special portal that doctors have placed in their stomach.
This can also be done automatically overnight with the help of a cycler, which is a machine that does almost all of the required fluid changes in a day, while a patient sleeps.
Juarez chose this over Hemodialysis, which requires patients to hook themselves to a dialysis machine, which acts like an artificial kidney by filtering a patient’s blood, 3 times a week for a period of 3 hours, while being assisted by a staff person at a clinic.
“I don’t have to go the clinic three times a week,” said Juarez, who said that this was important because he did want his kidney disease to affect his professional life as a plane technician. Further adding that he will soon be doing this with a cycler overnight.
However, not all patients have had such a positive experience with this treatment. In fact many patients who might have a desire for a more flexible schedule, but who underwent this treatment abroad, such as in neighboring Mexico, are afraid to start it over again.
Automatically limiting their choices of treatment.
“I am more calm with [my Hemodialysis] treatment,” said Jose Gomez, 43, who had bad experience with the peritoneal treatment in Mexico, which is the most common form of dialysis because of its lower cost. “I needed to stay at home an awful lot in order to carry out the treatment three times a day.”
Alejandra Vazquez, a nurse who trains patients on using peritoneal dialysis at the Satellite Dialysis Center, says that the problem with a lot of the bad cases that she has stumbled upon from Mexico, or elsewhere in Central America, are related to tougher economic realities and training.
“They will not have complete dialysis if they do it three times a day instead of four,” said Vazquez, adding it is not necessary for a person to stay at home, especially if they have an overnight cycler machine. “Why don’t some do it four times in Mexico? Because of a lack of money.”
Bad experiences abroad have also kept other patients from even trying the more flexible treatment, because of bad experiences from relatives.
“I am curious about trying it, but I am afraid that my condition will deteriorate,” said Oliva Garcia, 46. “I have relatives in Mexico who did not last long while undergoing the peritoneal treatment.”
Doctors admit that there is probably cultural element as to why some choose a treatment over the other.
“There is cultural component, in the sense that in some developing countries, the peritoneal technique was perhaps not as good,” said Dr. Stephen Lui a nephrologist at the Satellite Dialysis Center. “ So [some patients] get turned off by it.”
In the United States, most CKD patients actually choose Hemodialysis, but they do so because of choice and not bad experiences, said Dr Lui.
“Here is a matter of preference,” said Dr. Lui, who said that some patients do rather spend a longer time in Hemodialysis, because it requires them to do it fewer times a week, for example.
Both are overall are just effective, and differ in the time increments that are required to effectively perform the filtering of toxins in a body, said health professionals at the clinic.
“They are both just as effective,” concluded Dr. Lui.