Answer: Certainly, with the condition that you are able to learn how to perform the fluid exchanges and that the fluid exchanges in your abdomen remove enough chemical wastes and water to maintain your health. As is true for the selection of all other complicated treatments when there is a choice, the decision to have peritoneal dialysis or hemodialysis must be an individual one. But, the decision isn't forever; it is possible to switch from hemodialysis to peritoneal dialysis or vise versa at almost any time. In some cases, the change is forced by medical indication. As mentioned above, there are very few reasons not to choose peritoneal dialysis as a form of renal replacement therapy. The absolute contraindication for peritoneal dialysis treatment is if one's peritoneum has scar formation or adhesion secondary to multiple abdominal surgeries and the peritoneum becomes ineffective in delivering adequate dialysis. In fact, this is the common reason that leads to a switch in treatment from peritoneal dialysis to hemodialysis.

Question answered by Yalem Woredekal, MD. Dr. Woredekal is an Assistant Professor of Medicine and a Medical Director for the King County Ambulatory Hemodialysis Unit. She has also been a dialysis patient for the past 17 years and is currently on daily dialysis.

The Dear Doctor column provides readers with an opportunity to submit renal related health questions to healthcare professionals who specialize in the area of concern. The answers are not to be construed as a diagnosis and therefore, altercations in current healthcare should not occur until the patient's physician is consulted.

This article originally appeared in the March 2002 issue of aakpRENALIFE, Vol. 17, No. 5.

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