A Sticky Situation: Patients' Rights and Options Regarding Cannulation in Hemodialysis
Jim walked into the dialysis clinic and, while he put what he brought with him next to his chair, looked around. He saw the charge nurse and four technicians. He had been "stuck," or had the needle inserted into his arm, by everyone in the room and recalled that one of the technicians had done an excellent job the last time. She had hurt him very little and positioned the needles just right. This resulted in an uneventful treatment. He knew the others also, but none of them had been able to "stick" him as well.
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Adequate or Optimal Dialysis (Podcast)
A frequent term that is used in the dialysis industry is adequate dialysis. Lori and Stephen talk to Dr. Raffi Minasian on how the industry is recognizing that patients need more dialysis to feel better and improve their quality of life. Dr. Minasian explains some of the benefits of more dialysis and the barriers health care professionals encounter to be able to deliver optimal dialysis to their patients
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Bush Baby Travels the Globe - Learning about Love, Joy, and Support While Living with Kidney Failure
This is a story about a little stuffed koala bear-like animal that has traveled the globe to visit people with end-stage renal disease (ESRD), bringing them love, joy, and support from fellow travelers with kidney failure. The tiny toy creature, called "Bush Baby," has journeyed to five continents, staying with one enthusiastic host or hostess after another.
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Calciphylaxis (Podcast)
This week Lori and Stephen visit with Sue Vogel, renal administrator, nephrology nurse, and board member of Renal Support Network, to discuss calciphylaxis, a condition affecting kidney patients and transplant patients. You may be saying, "CalciphyWHAT?" Calciphylaxis (cal-si-fa-lax-sis) is a difficult-to-pronounce disease process that is very important for patients to know about. It involves a calcium and phosphorus imbalance in the body.
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Choosing and Caring for Your Vascular Access (Podcast)
On this week's show, Lori Hartwell, Stephen Furst, and their guests talk about the all-important vascular access. The access is how your dialysis staff (or you, if you practice self-care) gain entrance to your bloodstream to perform hemodialysis. The access is so important to hemodialysis patients that it's often called their "lifeline."
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Creating & Implementing the Rules for Dialysis (Podcast)
Congress passed legislation last year that will require CMS to write the rules on the payment policy for dialysis services. Mike Paget, who has many years experience in the dialysis community will explain how the renal community can be sure to be involved in the process. Any day now CMS will publish a "proposed rule" on the new payment policy for dialysis care, in the Federal Register. The community will have 60 days to comment, after which CMS will review the comments to establish the final rule. Listen to the show and learn how you an make an impact and what some of the key issues are.
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Dialysis Success (Podcast)
On this week's show, Lori Hartwell and Stephen Furst talk with a spirited woman who embodies the wonders made possible by dialysis. The definition of "dialysis success" for this long-time kidney patient, Roanne Dale, is looking great and feeling great while on dialysis. While this might sound like an oxymoron, one look at Roanne proves that dialysis success is achievable. Roanne's experience with kidney failure began back in the early 1970s. While on a tobogganing adventure with family members (for those of you from warm climates, a toboggan is a type of snow sled), her younger sister had a traumatic accident resulting in severe injuries. Because of the injuries, Roanne’s sister suffered kidney failure.
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Dialysis Without Fear (Podcast)
The Offer Family went through a crisis that many kidney dialysis patients know about: going from leading a carefree, regular life one day to walking into a dialysis clinic for treatment the next. But Daniel Offer is a physician as well as a medical researcher and professor at a university. He was still shocked, as was his family, which includes his wife and his daughter. So they wrote a book together called Dialysis Without Fear to help other people going through dialysis treatments
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Did You Know? Willem J. Kolff, MD, the Father of Dialysis
Willem J. Kolff, MD, the Father of Dialysis
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Did You Know? Belding Scribner, MD, the Father of Chronic Dialysis, Made History in 1960?
Belding Scribner, MD, the Father of Chronic Dialysis, Made History in 1960
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Did You Know? The Term ‘Dialysis’ was First Used in Glasgow, Scotland, in 1861
The Term ‘Dialysis’ was First Used in Glasgow, Scotland, in 1861
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DOPPS: Dialysis Outcomes Around the World (Podcast)
DOPPS stands for the Dialysis Outcomes Practice Pattern Study. This study was developed because there was a concern here in the US about 10 years ago that our kidney patients weren't living as long or doing as well as other kidney patients around the world, although there wasn't proof of this. Now this marvelous study reveals just how well we compare to other kidney patients in the other 12 countries studied. Did you know the police will be called to pick you up if you skip a dialysis treatment in ? No, it's not here in the U.S., but listen in to find out which country does this. Oh, wow! Would they come after you?
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Getting Off to the 'RightStart'
When she first started dialysis treatments, Maurita felt like there was a black cloud over her head. That's until she started the RightStart Program, an educational plan being tried in some clinics that helps patients starting dialysis better understand their dialysis treatment. Once she finished the program, she actually started looking forward to going to her treatments because she understood that they were helping her lengthen her life, to continue being with her family. Now, she even provides encouragement to other new patients. She says she hasn't felt this good in a long time.
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Having a Voice in Healthcare
It can be difficult to understand all the complexities involved in these discussions in the houses of Congress and how changes will impact people who have kidney disease. WeKAN (a patient advocacy program of RSN) works hard to stay on top of the issues that will affect kidney patients. Currently these are our top legislative advocacy issues:
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Hemo for Night-Owls (Podcast)
A kidney patient since she was 11, Diana Headlee-Bell has had two transplants and, since her second kidney transplant rejected, has been in in-center nocturnal hemodialysis 3 nights a week for 9 years. Why she likes it and how she manages it are two of the many questions Stephen and Lori ask. This alternative therapy modality can have many benefits. Listen to the show to find out what they are and –above all– discover another hemodialysis modality!
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How Do They Know You Are Okay? Measuring Quality of Care in Dialysis (Podcast)
This is a tough topic, but a necessary one to understand how the dialysis providers measure the quality of your care. Vincent Dennis, MD explains the proposed quality measures (anemia, bone and mineral metabolism, dialysis adequacy and infection) that are monitored carefully and overseen by Centers for Medicare and Medicaid Services. It is important that people with kidney disease understand that when a measure is set, it becomes the target for the healthcare provider and patients can suffer if they get it wrong.
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How Low Can You Go? (Podcast)
How low can you go? What are we talking about? This week we're talking about understanding low blood pressure while on dialysis. Stephen knows firsthand how low he can go. He experiences low blood pressure frequently while on dialysis. He also experiences some of the symptoms of low blood pressure such as headache, sweating, and cramping. Collectively, these signs and symptoms are frequently referred to as "crashing".
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How to Make the Holidays Hassle Free - and Add a Sprinkle of Joy!
The holidays can be full of joy and lasting memories. But they can also add stress in our lives, especially when we are balancing the many issues kidney disease brings to us. Here are a few suggestions on how to enjoy the holidays with fewer hassles:
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I Want More Dialysis...Please!
Many of my current dialysis patients as well as others around the United States are asking for more dialysis. They want to feel better and "get their lives back." Allowing them to perform their own dialysis in the home setting and receive more total hours of dialysis is empowering. Patients have shared with me and I have witnessed how much better their lives can be when they receive the optimal amount of dialysis. So are you receiving optimal dialysis, or just adequate dialysis? This is a hot topic right now in the corporate kidney world, and should be among dialysis patients as well.
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Independent Living with Home Dialysis (Podcast)
What a great week to talk about home hemodialysis... the week of Independence Day. Our guest is Hasmik Mouradian, who knows about dialysis and the independence that home hemodialysis can offer. Hasmik began dialysis when only 16 years old. Not knowing what was wrong, her parents took her to the doctor because she had swollen legs. "The next thing I knew, I had to start dialysis," says Hasmik, who was living in her native country of Armenia at the time
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Informed, Committed, Understanding Legislators
We see our elected leaders on television, we read about them in the newspapers, and sometimes we even encounter them in person. Most of the time these elected officials are doing the talking—they tell us about themselves, their plans, their policies, and their problems.
Election season turns things around. Now, it's our turn to speak, and our leaders must listen. They know that to get our votes they will need to understand our interests and concerns.
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It's About Choice: A Benefits vs. Burdens Analysis
"If I couldn't see my life improving on dialysis, I wouldn't want to live."
Many patients make similar statements to show how they feel or how they think when faced with the burdens of dialysis. If they are suffering losses in physical or mental function, they might see their quality of life falling to a level lower than what they could accept. They might choose to simply stop dialysis.
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Living Long and Well on Dialysis
Your medical team should explain all the different treatment options to you so that you can make an informed decision. Do some research on your own. There is a wealth of information on the Internet. Learn more about the different options and then make a choice that works for you and your family.
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Longer Hemodialysis Is Better than Shorter Hemodialysis
Even one hour longer on dialysis will bring remarkable improvement within only a few weeks! The longer dialysis duration is particularly beneficial in patients who do not make any urine.
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Medication Reconciliation: A Practical Guide For Dialysis and Transplant Patients
We’ve all heard the stories about people who were given the wrong medication or the wrong dose of medication in the hospital. These stories often have devastating outcomes, and people become scared of the care that is being provided by healthcare workers.
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Metformin
A popular oral drug for treating Type 2 diabetes. Metformin (brand name Glucophage) is a member of a class of drugs called biguanides that helps lower blood sugar levels by improving the way the body handles insulin-namely, by preventing the liver from making excess glucose and by making muscle and fat cells more sensitive to available insulin.
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My Journey as a Peritoneal Dialysis Patient to a Normal Life
No doubt, like anyone else who deals with chronic illness, I wondered with amusement if I even knew what a “normal” life is anymore. How could I--with PKD and CKD that led to PD (as well as all those other mysterious combinations of medical letters)?
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Nutrition Tips For Enhancing the Dialysis Patient's Quality of Life
Good nutrition is a very important part of your renal treatment plan whether you are on hemodialysis (HD) or peritoneal dialysis (PD). To move forward with your best in all aspects of your life as a kidney patient, make an effort to maintain yourself by eating enough of the right kinds of foods or less of those "forbidden" foods.
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Opinion - How is Dialysis Paid For in the US?
The title of this article seems like a simple question, but it's a complicated situation, so there really is not a simple answer. In 2004 (the most recent year for which data are available), nearly 500,000 people had Stage 5 chronic kidney disease (CKD-5, a condition so severe that to live a person needs either a kidney transplant or regular dialysis treatments), and 336,000 individuals were treating their CKD-5 with either hemodialysis (HD) or peritoneal dialysis (PD).
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Overview of Hemodialysis
Hemodialysis (HD) is a treatment option for kidney failure. When confronted with the seriousness of renal or kidney failure, most patients find it difficult to understand all of the various aspects of their treatment. There are many questions that go unasked and unanswered. For example: "How does the artificial kidney or dialyzer work?" Another question commonly asked is: "I see blood going through a series of tubes. What is happening to my blood?" Read on to find the answers to these commonly asked questions.
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Pet Therapy: Wagging Tails Come to You
Not only is a warm fuzzy face or a wagging tail a friendly distraction, but spending time with therapy animals can actually have physical benefits as well. Studies have shown that interacting with animals can lower blood pressure, reduce anxiety and stress, and generally calm a person. As a dog, cat, or other animal offers loving and empathetic support, it also helps aid healing.
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Policing Kidney Disease (Podcast)
This week’s guest on KidneyTalk is Donald England, a full-time, on-the-beat police officer who is also a kidney patient. With an abdomen full of peritoneal dialysis fluid (he uses the CCPD cycler at night), Don patrols the streets of Kokomo, IN, keeping its citizens safe. Don shares his story of living a successful life, including managing kidney disease. Tune in and listen as Don talks with Lori and Stephen about his work as an active duty officer (he will be featured in an upcoming show on the FBI Files) and some of the important things kidney disease has taught him. You will be inspired by Don’s honesty, openness, and attitude about life!
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Preparing for Emergencies: A Guide for People on Dialysis (3-Day Emergency Diet Plan)
Emergencies caused by severe weather or disasters can happen with or without warning. This helpful 3-Day Emergency Diet Plan prepared by CMS, provides useful information and tips to aid you in your emergency preparedness so you can feel better and stay healthier.
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Preserving Your Lifeline: What You Should Know About Vascular Access Monitoring and Surveillance
As a patient using a graft or fistula for dialysis, one of your highest priorities for maintaining your health and well-being is to make sure that your vascular access is working properly. Problems with your access can decrease the effectiveness of your treatments and lead to hospitalization or loss of your access. What can be done to help keep your access working properly?
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Redsense is Ready to Make a Difference
In a world full of alarms and monitors, finally there is a FDA approved device to help detect the worrisome, potentially life threatening complication of dialysis, Venous Needle Dislodgement (VND) at home.
For those patients who choose the flexibility and freedom of home dialysis, the Redsense alarm is a welcome piece of mind. Few, if any, other serious complications of dialysis cause more concern than the unpredictable nature of a VND. It's known that it can occur without warning even under the best situations. Patients are educated on precautions that can be used to reduce the likelihood of having one, but the fact remains, it can't be accurately predicted.
Now that Redsense is available for home use, dialysis patients now have an additional layer of security to help ease their minds.
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Smart Snacking Choices for the Dialysis Patient
Hungry? Not sure what to eat when you get the munchies? The following are some ideas on what to eat in between meals to help you maintain your nutritional well being without all that extra potassium and phosphorus. Each “smart snack" contains less than 130 milligrams (mg) of potassium and less than 80 mg of phosphorus. Check with your renal dietitian on the number of servings that are appropriate for you.
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Take-Home Dialysis (Podcast)
Wouldn’t it be great if dialysis was like the Domino’s Pizza delivery policy... delivered in 30 minutes or less? Although 30-minute dialysis is still a long way off, shorter hemodialysis treatments are here today and growing in popularity, especially since they can be performed in the comfort of your own home. On this week’s show, Lori Hartwell and Stephen Furst talk with two physicians who address both the convenience and clinical benefits of daily home hemodialysis.
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Taking Charge of Your Dialysis & Your Life! (Podcast)
Susan Hansen RN, CNN, Director of Clinical Business Development at Renal Solutions, Inc., chats with Lori Hartwell and Stephen Furst about taking charge of your dialysis and your care. Sue’s knowledge and experience go back to 1965, during the beginning stages of maintenance / chronic dialysis.
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Taking Dialysis on the Road (Podcast)
“On the road again....” Four simple words that once seemed impossible for dialysis patients. But not any longer! On this week’s show, Lori Hartwell and Stephen Furst talk with someone who helps make dialyzing in another city or state (or even another country) a lot easier. There was a time when it was difficult to arrange treatments for hemodialysis patients who wanted to travel. Dialysis facilities didn’t always have openings for patients who wished to receive only one or two treatments. The facilities also may not have had enough staff to accommodate visiting patients. Thankfully, times have changed.
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The Advantages of Home Nightly Nocturnal Hemodialysis
The renewed interest in this modality is the result of several recent studies on improving the quality of dialysis. These studies have demonstrated very well that nocturnal dialysis patients are doing much better than they have done on standard in-center dialysis.
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The Courage to Live
My doctors told me that my kidneys would function for about six more years. After that, I would either have to begin dialysis, have a transplant, or die. As a mother, this frightened me. My daughter was just a few weeks old, and my son was only four. I was terrified. I did not want to die and leave my children without a mother.
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The Good Dialysis Index
The "Good Dialysis Index" (GDI) potentially offers a more humane model of the dialysis patient as a whole. The GDI design attempts to mirror more closely the things that matter - not only to the nephrologist but to the patient - in the delivery of 'good dialysis'. Certainly, it serves this aim better than does the urea-centric, mathematically limited concept of Kt/V, restricted as it is to the narrow confines of small solute clearance. The GDI remains to be rigorously tested and validated as a predictive tool in the dialysis population, but it has certainly been simple and quick and easily applied when run against a small pilot patient group.
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The Heart of Kidney Disease (Podcast)
Dr. Carol DiRaimondo, an internist specializing in kidney diseases, gives some no-nonsense, straight-as-an-arrow talk about why it’s vitally important for people with kidney disease to take care of their heart—and how to do it. Because patients on dialysis are at a higher risk for heart disease, they will be especially empowered by this discussion. Find out what you can do to prevent heart disease or work your way towards a healthy heart in this information-packed show
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The Kidney Connection - Anemia and Kidney Disease
Anemia can be either a temporary or a long-term disease/illness. People with mild anemia may not have any symptoms, or they may have only mild symptoms. Those with severe anemia can feel tired, get short of breath with activity, and have problems doing the things they usually do.
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The Kidney Connection - Diabetes Mellitus
Only 5%-10% of those with diabetes suffer from the more serious type 1 diabetes. In this type, the body stops making insulin, resulting in the need for the patient to take insulin daily.This type is more likely to lead to kidney failure. Up to 40% of those with type 1 develop kidney failure by the age of 50.
The vast majority (90%-95%) of diabetic patientshave type 2 diabetes and do not require daily insulin doses. Type 2 most often occurs in people over 40, but can occur at any age. Many are overweight and do not know they have the disease.
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The Kidney Connection - Glomerulonephritis
Glomerulonephritis (GN), also known as glomerular disease, can be either acute such as a sudden inflammation attack or chronic, which occurs gradually. It can occur as part of a systemic disease like diabetes or lupus or it can be a disease on its own, known as primary GN.
Mini-epidemics of the condition have occurred in certain geographic areas and is most common in individuals aged 40 to 60. The condition sometimes runs in families, indicating a genetic factor.
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The Kidney Connection - Hemolytic Uremic Syndrome (HUS)
Hemolytic uremic syndrome (HUS) is the most common cause of sudden, short-term kidney failure in children, and is most common in kids aged six months to four years. While the condition is more prevalent in children, adults can also get it. Progression to acute kidney failure occurs in about 50% of HUS cases.
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The Kidney Connection - Hypertension
What is hypertension, or high blood pressure (BP)? It's when the force of the blood pumping against the walls of your blood vessels is too high. This causes your heart to struggle to pump blood through the arteries to the rest of your body. Hypertension also damages the blood vessels by making them more narrow and their walls thickerand "harder" (a.k.a atherosclerosis, or hardening of the arteries).
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The Kidney Connection - IgA Nephropathy
IgA nephropathy, also called Berger's disease, was named for the doctor who originally discovered the condition in 1927. It is caused by abnormal deposits of a kind of protein that helps fight infection known as immunoglobulin A (IgA) inside the glomeruli (small blood vessels of the kidneys), resulting in inflammation of the glomeruli.
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The Kidney Connection - Lupus Nephritis
Lupus is short for "lupus erythematosus." The word "lupus" is the Latin word for "wolf." It was named because of the skin rash resembling a wolf's bite that some patients get over the bridge of their nose.
Lupus is an autoimmune disease because the immune system, which usually protects the body from illness, turns against it. This causes harm to organs and tissues, including the skin, joints, kidneys, and brain.
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The Kidney Connection - Renal Bone Disease
Many patients with chronic kidney disease (CKD) are unaware that the kidney is involved with the health of their bones. Renal bone disease (a.k.a renal osteodystrophy) occurs when your kidneys fail to maintain the proper levels of calcium and phosphorus in your blood.
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The Kidney Connection - Restless Legs Syndrome
Restless legs syndrome (RLS) is a movement disorder that causes uncomfortable, unpleasant sensations in the legs. It affects up to 10% of the US population and as many as 40% of those on dialysis. The condition mostly affects older individuals.
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The Kidney Connection - Secondary Hyperparathyroidism
The most common cause of SHPT is CKD. SHPT occurs when damaged kidneys do not convert enough vitamin D to its active form or they may not excrete enough phosphorus.
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The Kidney Connection - Sex and Sexuality
What is sexuality? Many believe it refers only to sexual intercourse, but it actually has a much broader definition. It also refers to self-image, how you communicate with other people, and simply building a relationship. It includes such activities as touching, kissing, and hugging, or just being with each other and participating in activities you both enjoy.
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The Kidney Connection - Skin and Hair Problems
Skin and hair problems affect many people on dialysis. As a dialysis patient, your skin may appear to be more fragile and may tear or bruise more easily than normal.
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The RightStart Program (Podcast)
Do you remember how you felt when you started dialysis? Anxious, scared, and with endless questions? This new pilot program called "RightStart," is designed to educate and help new patients feel better and more in control of their health during this critical time. Rebecca Wingard, Nephrology Nurse and Vice President of Quality Initiatives for Fresenius Medical Care, joins us today to talk about the RightStart Program.
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The Use of Peritoneal Dialysis in the Management of Kidney Failure
Peritoneal dialysis (PD) is one of the generally available and internationally used forms of treatment and management of patients who reach end-stage kidney failure. It is the primary form of treatment for renal failure used at home and for self-dialysis.
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The Warmth of an Idea for Your Vascular Access
I was diagnosed in 1971, so I have known for years that kidney failure was probably in my future. I began hemodialysis in May of 2006. I have an upper arm AV fistula, and while on dialysis found that my access arm got uncomfortably cold. Those of you on hemo know that we can't cover the access arm because the needle site has to be visible to staff at the center at all times.
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Tips on Adhering to a Medication Regimen For the Dialysis and Kidney Transplant Patient
As a dialysis or kidney transplant patient, you know that taking medication the way it is prescribed is one of the most important things you can do to help keep yourself as healthy as possible. Even though you know how important it is, medication is not always the easiest thing to swallow.
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Understanding Anemia: Learn all you can about this energy draining condition (Podcast)
Okay, all you couch kidneys out there, listen up! (We can’t be couch potatoes because we have to watch our potassium, right?!). Do you feel tired? Out of energy? Cold? Have you failed the “stair test”?
On KidneyTalk this week, Lori and Stephen discuss anemia (a complication of chronic kidney disease) with Dr. Mahesh Krishnan, Medical Director of Amgen in the Dialysis Services Department and author of The Kidney Guide.
Dial in to your favorite Internet station − KidneyTalk − and learn why you need to know about anemia, how it affects kidney patients, the treatment for it, and other important issues regarding this energy-draining disease. You’ll also find out how to energize yourself and stop being a couch kidney!
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What In The World Is Mineral and Bone Disorder (Podcast)
A Nephrology nurse since 1970, Gail Wick has seen treatment for chronic kidney disease improve considerably. But one of the hidden side effects, happening long before kidneys fail, is secondary hyperparathyroidism, now known as Mineral and Bone Disorder. Find out what it is and how to cope with it from an expert.
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What Patients Need to Understand About Quality Assurance in the Dialysis Center
Quality assurance and continuous quality improvement (QA/CQI) are critical components in the hemodialysis (HD) center. Correctly implemented and managed, QA/CQI not only improves outcomes that have been established by the Centers for Medicare and Medicaid Services (CMS), the End-Stage Renal Disease (ESRD) Networks, and the individual dialysis companies, it also improves the quality of life for the HD patient.
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Why Can't I Get Medigap Insurance? (Podcast)
Supplemental Medigap insurance is a must when you have kidney disease. Unfortunately, dialysis patients are denied access to Medigap insurance in over 20 States. Wendy Funk-Schrag and Lori Hartwell discuss how this impacts patients and what you can do to educate your elected officials to help change this unfair public policy.
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Why Do Patients Have Bouts of Low Blood Pressure During Hemodialysis?
While most people who eventually require chronic maintenance hemodialysis (HD) had hypertension, or high blood pressure (BP), before they began HD treatments, hypotension (low BP) during the HD treatment sessions is a common problem. It is estimated that 15%-50% of patients receiving HD will have low BP during their treatments.
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