History

In May 2013, I faced dialysis for a second time, but the changes to my life from renal (kidney) failure began in 2000. So the initial posts will express my experiences as a new kidney patient, cover the transplant briefly, and move on to the dialysis treatments I have undergone since May 2013.

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Why do patients who make urine have to be on dialysis?

SURVIVAL TIP: If you are fortunate enough to still make urine, use the time to train yourself to drink fluids that fit into a renal diet. Water is the best drink for your kidneys. Choose to make water your primary source of liquid refreshment. You can begin limiting dark colas, coffee, hot chocolate, orange juice and alcohol. Ask your nutritionist if you have questions about flavorings or drinks you should work to remove from your diet and how much fluid you should drink daily. Generally dialysis patients should drink only what they expel between treatments.

Some dialysis patients who are on dialysis still urinate. mineral-water-lemon-lime-1532300_1280These individuals require dialysis to clean their blood because of high creatine levels. Although their kidneys still make urine, the bean-shaped organs don’t sufficiently remove toxins from the blood.

Kidney failure, or end-stage renal disease (ESRD), is caused by a number of factors and health conditions. Contributing diseases affect urine production differently.

 Did YOU KNOW that your body doesn’t always make urine just because you consume fluid? When the kidneys begin to fail, you make less or no urine. That’s why your doctor, nurses, and nutritionist want you to manage (limit) your fluid intake. The longer you are on dialysis, the less urine you make because your kidneys continue to decline. So if you don’t eliminate fluid through urination, you carry it in your bloodstream and tissues until dialysis removes the fluid and toxins.

Most dialysis patients no longer make urine. Anuria is the term used when kidneys no longer make urine. When I asked another patient early in my dialysis experience, he told me most people stop urinating after about three years. I found that to be true but still made minimal urine after three years. Reduced urine output is called oliguria. Although I didn’t measure but by the third year, I believe I was down to making about a half-cup per day in two or three daily bathroom visits. Using a public restroom beside someone with a full bladder reminds me how little urine I make.

Urinary Tract Infections (UTIs) are common in dialysis patients who don’t pass urine. Women should try to urinate after

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Microscopic Bacteria

sexual intercourse to wash away bacteria that could have been introduced to the urethra (the tube that leads from the bladder to outside the body). Women also get UTIs more frequently than men because the urethra is shorter in females.

Many changes happen in our bodies when we rely on dialysis. If you have questions about changes, ask patients you feel you can trust or your team of dialysis professionals. We feel more calm and less fearful if we know that what is happening is normal or can be treated.

If you or someone you care about is facing dialysis, share your experiences and concerns. This is a forum for learning and inspiration where we can ask questions and be honest with others in the same situation. What are your experiences and challenges with dialysis?

RESOURCES
https://www.davita.com/kidney-disease/overview/symptoms-and-diagnosis/most-common-questions-kidney-patients-ask-doctors/e/4729
https://kidneyfoundation.wordpress.com/2013/02/24/why-do-some-dialysis-patients-urinate-and-some-do-not-how-long-can-someone-be-on-dialysis/
https://www.davita.com/kidney-disease/dialysis/treatment-options/how-dry-weight-and-fluid-gain-affect-dialysis-patients/e/5273
If you would like Beth, the Dialysis Gal, to speak to your group, reach out via dialysisgal@gmail.com or in the comments.

 

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Delayed treatments always a risk

SURVIVAL TIP: Plan to keep your fluid below goal every day in case you can’t get to treatment.

Snowy RoadMany of us in the United States were affected by storms that blew across the country during early January. I was lucky to be in a zone that got more rain than snow, but we still had icy streets. Others in our area got considerably more snow than we get most years.  Continue reading

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You have choices among dialysis centers

SURVIVAL TIP: Your nephrologist (kidney doctor) will likely refer you to a dialysis unit, but patients have choices.

TransportIf your town or city offers more than one dialysis clinic and you are unhappy with your unit, take advantage of the opportunity to “travel”. Ask your unit to assist you in visiting another unit. Fresenius patients can call a central number, but my experience is that they only file requests. Operators do not answer questions about specific units. A flurry of faxes travel from office to office and take up to several days to secure confirmation. If your clinic is different, let us know in the comments below.

If you want to stay with the doctors who manage your unit, call the doctors’ office and ask what other units under their care meet your needs. Some units are full and cannot accept other patients. Sometimes shifts are full, but you might be able to get a different schedule. The clinic I chose wants patients to make the calls to see what units are available when we travel. I narrow down the clinics through web research and then call the preferred unit to ask if they can accommodate me. Often the clinic coordinator will provide helpful information in guiding me to a unit that can accommodate me.

While you are visiting another unit(s), ask patients about their experiences. Does one tech or memory stand out? People generally want to share negative experiences, so you’ll hear all about those. So ask about good experiences. If you have a specific concern, ask other patients their experiences with the same issue.

Many providers offer in-clinic and at home services. Size varies greatly, from the size of the unit to the size of the company that owns the unit.

Comparisons
Ascending GraphMedicare offers comparisons of units at https://www.medicare.gov/dialysisfacilitycompare/. Consider that at first glance, data can be misleading, however. Depending on the age of patients and other health concerns, units can get low scores that don’t accurately reflect the quality care they provide. Call your local kidney advocate to get help understanding the data. I did!

Major providers
Fresenius and Davita are the two largest dialysis providers, but they are by no means the only companies or necessarily the best in your area.

Fresenius was established in 1912 with the production of pharmaceuticals in Germany. The company began selling dialysis machines and dialyzers made in other countries in 1966. By 1974, Fresenius was making their own machines and dialyzers. Today, the company continues manufacturing and provides health services, such as hospitalists and other medical providers; pharmacy services for dialysis patients; outpatient labs; and urgent care centers. This publicly traded company provides dialysis treatments to many in-hospital units and sells their dialysis machines and dialyzers to other dialysis providers.

Did YOU KNOW that Fresenius Medical Care, DaVita Kidney Care, and Baxter Renal Care have clinics overseas?

DaVita began providing dialysis services in 1999 and is traded on the New York Stock Exchange. According to the website, DaVita focuses on patient care and outcomes. The website is easy to navigate and provides exceptional resources.

Smaller providers
The third largest company cares for 150-160,000 fewer patients than DaVita or Fresenius, respectively. The next seven care for significantly fewer patients. But this in no way suggests inferior care.

Dialysis Clinic, Inc., and Satellite Healthcare are both non-profit dialysis providers.

If you are not happy with your unit, ask around. Visit other units. Do you research. Make a list of your top requirements. Location? Doctors? Staff? Available shifts? Corporate ownership? One unit is not going to offer all you desire, but you will find one that provides care from staff and/or doctors you believe you can trust. Select the unit that best meets your needs. Dialysis is your lifeline.

If you or someone you care about is facing dialysis, share your experiences and concerns. This is a forum for learning and inspiration where we can ask questions and be honest with others in the same situation. What are your experiences and challenges with dialysis?

RESOURCES
http://www.freseniusmedicalcare.com/en/about-us/history/

http://fmcna.com/company-profile/

http://www.nephrologynews.com/largest-dialysis-providers-2016-poised-change/
http://catalyst.nejm.org/the-big-business-of-dialysis-care/

If you would like Beth, the Dialysis Gal, to speak to your group, reach out via e-mail or the comments.

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9 tips for a budget- and kidney-friendly diet

SURVIVAL TIP: A kidney-friendly diet incorporates many aspects of a standard nutritious diet and can be tailored for dialysis patients with a few changes.

Making Egg SaladAre you overwhelmed when you look at the eating plan your dietician recommended? Omit this. Reduce that. Eat lots of protein and drink water. I was overwhelmed, too, but a few tips helped me adapt. Continue reading

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Can you eat well on a budget?

Healthy foodYou already know that dialysis requires learning about your new lifestyle, diet, exercise, and scheduling.

Learning, paying attention, and putting this new lifestyle into practice can be difficult when you are already tired. So how do you incorporate eating well on a budget into all of the other changes in your life?  Continue reading

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Do I need a baking soda supplement?

Survival tip: Some patients need a sodium bicarbonate supplement to reduce the acid in their blood. Your doctor will prescribe tablets if you need to add this to your diet. The tablet is easier to swallow than a spoonful of baking soda and is the same thing!

The final lab that I mentioned in the post about important lab values is sodium bicarbonate. This tablet is simply a perfectly measured easy-to-swallow tablet made from baking soda like you use in the kitchen or put in the refrigerator. If you drop the tablet into water, it immediately breaks down into powder.  Continue reading

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Calcium is important, but limit intake

SURVIVAL TIP: The renal diet is challenging. No one knows that better than you. But the key to success is moderation. Aside from alcohol and illicit drugs, we can have a taste of anything we want. You can have milk, dairy products, and puddings. If you find limiting your eating or choices to be challenging, take the challenge. You will be glad you control your food choices.

Cream Cheese with CrackersWe know that calcium makes strong bones and contributes to a healthy heart. Haven’t you heard: “Milk: It does a body good”? We all need calcium, but if you are managing your potassium and phosphorus intake like most dialysis patients, you have to enjoy calcium differently than you have in the past. We are not average consumers any longer. Continue reading

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