Dialysis & Kidney Transplant Planning
Unhurried, compassionate education on every pathway — home peritoneal dialysis, home hemodialysis, in-center treatment, preemptive living transplant, and conservative management.
What It Is
When chronic kidney disease progresses toward advanced stage 4 or stage 5 (eGFR below 20 mL/min), proactive planning ensures that patients never face emergency hospital dialysis with a temporary chest catheter. Advanced kidney care empowers you to choose the modality that matches your lifestyle.
Why Your Doctor May Have Sent You
Your kidney function has dropped into Stage 4 or Stage 5, and it is time to discuss future options calmly and without panic.
How Our Specialists Help
Dr. Hozayen sits down with you and your family for extensive, unhurried consultations. We explain every option: home peritoneal dialysis (PD), home hemodialysis, in-center daytime hemodialysis, preemptive kidney transplant (getting a transplant before ever needing dialysis), and comprehensive conservative medical management. We coordinate timely vascular access planning and refer you to premier New York/New Jersey transplant centers.
Diagnostic Workup & Testing
We avoid redundant testing by reviewing recent records first, ordering only targeted diagnostic studies:
- Serial monthly or bi-monthly renal function and electrolyte panels
- Vascular mapping (arm vein ultrasound for arteriovenous fistula or graft planning)
- Transplant center pre-evaluation workup coordination
- Peritoneal dialysis catheter surgical evaluation coordination
Evidence-Based Treatment Pathways
Modern renal medicine focuses on preserving existing nephrons and preventing complications:
- Preemptive kidney transplant referral to RWJBH, Hackensack University Medical Center, Mount Sinai, or Columbia
- Education and training on gentle, patient-empowered Home Peritoneal Dialysis
- Early arteriovenous (AV) fistula creation to completely avoid emergency central catheters
- Medical preservation of residual kidney function throughout the transition
Common Symptoms to Monitor
- Noticeable increase in daytime sleepiness or mental fatigue
- Persistent nausea, aversion to meat, or metallic taste
- Worsening fluid accumulation that requires increased diuretic doses
- Persistent itching (pruritus) not explained by skin conditions
When to See a Kidney Specialist
- eGFR reaches 20 mL/min/1.73m² or below
- You want to explore getting on the national kidney transplant waiting list
- You want unbiased education about doing dialysis in the comfort of your own home