Consumer Interest
Treatment Choices
End stage renal disease (ESRD) has many causes but no cure. When almost all kidney function is lost, one of the existing treatment types must be used to maintain life. You can choose the type of treatment that best fits your lifestyle and your medical condition.
Most ESRD treatment costs are paid for by the federal Medicare program. Medicare does not tell you where you must receive care. You make this choice. However, other factors can influence this choice.
Do you want to receive a transplant?
Do you want to start a type of dialysis?
Do you prefer hemodialysis or peritoneal dialysis?
Do you want to do the treatments at home?
There are many choices to make at the start of treatment and they can cause confusion. Some choices may not be suitable for you because of medical reasons. Your health care team will give you more information and help you make these choices.
If you want a kidney transplant, you may go to any Medicare-approved transplant hospital to receive one. If you have a different insurer you may be told to go to certain hospitals. These may or may not be close to where you live. You must make sure that the non-Medicare insurer will pay the transportation costs to the transplant hospital if it is not near where you live. Medicare pays no transportation costs to reach a transplant hospital.
Most often you want to be cared for by a particular doctor. Doctors have 'privileges' (are on staff) at certain hospitals and dialysis centers. Your doctor may not be on the staff of the dialysis facility closest to where you live. If you want to receive treatment at a facility where your doctor is not on staff, you may have to select a different doctor or go to the facility where your doctor is on staff. Discuss your concerns and choices with your health care team.
There are medical reasons why some forms of therapy cannot benefit some persons. Discuss any problems connected with a type of treatment with your health care team and choose the best type for you and your medical condition. Later, when you have been on dialysis for some time, or the transplanted kidney no longer works, you may decide to use another type of treatment, e.g. you may start on peritoneal dialysis (PD) and then switch to hemodialysis (HD) in the unit or at home.