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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Anemia and CKD: What Every Patient Should Know
Patients with chronic kidney disease often suffer from anemia. Anemia is a condition characterized by low numbers of circulating red blood cells. This condition is easily detected by measuring hemoglobin in the blood. How low should the hemoglobin be before the patient with chronic kidney disease experiences symptoms depends on the severity of anemia and the activity level and tolerance of the patient.
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Another Reason for Good Oral Hygiene
You've probably heard how brushing and flossing your teeth daily can help prevent cavities and gum disease, but there might be a new reason to find the energy to clean your teeth. It has to do with the relationship of your teeth and gums to the rest of your body.
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Are You Shooting Up?
When you pull out needles from your little black kit, people have a tendency to be fascinated. I think they also want to make sure you're not going to come after them with the needles! Managing diabetes isn't always easy, but it is necessary for optimal health.
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Avoiding the Telltale Symptons of CKD - What's the Cost? (Podcast)
Valerie Thomerson was both new on the job and finding a new home with her husband when she "just blew off all the symptoms," she said. She had all the warning signs but no family history of disease, and, besides, the new job called for all her attention. How did a security guard save her life? Why did the triage nurse have to take her blood pressure three times before he believed the reading? Now living with a transplanted kidney from a donor at her church, Valerie's story is both inspiring and fascinating.
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Blood Pressure Monitors
To get an accurate reading it is best to take your BP at the same time everyday using the same arm because results can vary between arms. BP can be affected my many things such as diet, emotion, and muscle tension to name a few.
Owning a blood pressure monitor is a great way to regulate your blood pressure. There are a few factors such as usability and accuracy that go into choosing the right monitor. The British Hypertension Society (BHS) provides highly regarded guidelines to manage high BP and also has lists of BP monitors that scored a "B" or better using BHS protocols.
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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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Delay the Need For Dialysis With Good Nutrition
People who have been diagnosed with decreased kidney function often find themselves confronted with many lifestyle changes, including their diet. But there are steps that can be taken to help prolong kidney function. Following the right diet is one way that you can help slow down the damage to the kidneys and delay the need for dialysis.
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Don't Wait For the World to Change (Podcast)
This week on KidneyTalk, we are on location at the Annual California Dialysis Council Meeting in Palm Springs, CA with Marc Chow, Director of Government Affairs for Satellite Healthcare and Mike Arnold, CEO of Arnold & Associates, Inc.
Mike Arnold says "Unless we're there to stand up for our community...we're forgotten about."
Ever feel that way?
In this interview Marc Chow and Mike Arnold offer their respective expertise on why it is so important for the kidney community to take a stand, get involved, and make a difference...and how. You'll find it's not as hard as you may have thought.
"Dialysis patients are different, it's a very fragile population. They need to be thought of differently, and treated differently, and must be addressed differently." Mike Arnold says.
Learn about the Kidney Care Quality and Education Act of 2007 and some of the state issues heading our way.
Be sure to tune in to this very informative interview, and make an impact that will help change kidney patients' lives...for the better.
To learn more about The California Dialysis Council please visit www.caldialysis.org.
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Drinking Alcohol Responsibly on a Renal Diet
Over 50% of American adults drink alcohol. Alcohol may have beneficial effects when consumed in moderation. This article will review what moderate drinking is, what is a serving size, and the health benefits of drinking.
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Easy Bruising
No one skates through life without an occasional bruise, whether it's a learning-to-walk toddler bumping into a coffee table, a harried worker inadvertently walking into the corner of a desk, or an amateur home handyman hitting a finger with a hammer. Such occurrences are seldom a cause for concern. For those with chronic kidney disease, however, frequent and easy bruising presents problems and challenges
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Ethnic Dining For the Renal Patient
You can try different ethnic foods on your renal diet! This guide will help you in making menu selections when eating away from home. Follow these general suggestions on dining out:
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Exercise Program Tips for Dialysis Patients
Although you see your physician regularly to control your blood sugar and your BP, what are you doing to increase your physical activity? It is equally as important--and maybe even easier to control--than BP and blood sugar. You can be more physically active, and it may just save your life.
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Fast Food Facts
Quick-service restaurants provide us with a quick, easy, inexpensive bite when we're pressed for time.
If you are a regular through the drive-up window or frequently dine in at fast food restaurants, keep these tips in mind:
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For Women Only! (why is Stephen in the room?) (Podcast)
Dr. Josephine Hall, MD, a Board-certified gynecologist, has been practicing medicine since 1968, and has been an OB-GYN since 1970. Dr. Hall talks woman-to-woman with Lori Hartwell, as co-host Stephen Furst asks the questions every guy wants to ask! Dr. Hall offers important insights about female concerns that are shared by people who have chronic kidney disease.
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Gaining that Winning Smile (Podcast)
On this week's show, Lori Hartwell and Stephen Furst speak with Cheryl (" Cher ") Thomas, a registered dental hygienist and kidney transplant recipient, who brings up the intriguing relationship between gum disease and one's overall health. What brings a smile to your face? A sparkling, silvery, five-pound fish on the end of your fishing line? A quiet evening with a good book? Or maybe even a crisp, juicy, red apple? For Lori, it's all about dogs. "When my two dogs are playing and tumbling around, it just makes me smile," she relates.
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Get Information, Get Tested, Get Hope! (Podcast)
Dr. Roberto Vargas works hard at preventing kidney disease, and working for the best outcomes if someone already has it. In this invaluable show, you will learn what the early warning signs of kidney disease mean, why some minority cultures are at higher risk, and the importance of getting tested, especially if there's been kidney disease in your immediate family. Dr. Vargas holds out hope for patients not to progress to a higher stage of CKD, and even, when conditions are favorable, to regress back to an earlier stage. This is a must-listen for everybody - diagnosed or not.
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Gout and CKD - A New Era of Hope
It was not until 1962 that scientists discovered that gout is caused by the excess accumulation of monosodium urate (MSU) crystals in the tissues surrounding joints. Uric acid (also known as urate) forms in the body as the natural process of protein break down. Normal levels are less than 7.0 mg/dL. Many people who have chronic kidney disease experience their first attack as their kidney function progressively declines due to reduced urinary excretion of uric acid.
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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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Health Promotion, Disease Prevention, and Chronic Kidney Disease
These are but a few ways you can maintain a healthy lifestyle. As you take a more active role in your own healthcare, the benefits of increased energy, general well-being, and a potentially longer life are all possible.
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Help Your Family Make the Kidney Connection
Twenty six million Americans have signs of kidney damage based on urine or blood tests. People of all ages and races are at risk for kidney disease, but African Americans are much more likely than other groups to develop kidney failure, which is severe kidney damage requiring treatment with dialysis or kidney transplant. In fact, African Americans are four times more likely than Caucasians to be diagnosed with kidney failure.
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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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How Your Kidneys Work and the Five Stages of Chronic Kidney Disease
Kidney disease is the loss of the kidneys' ability to adequately perform critical functions important to maintaining life. Most renal diseases destroy both kidneys simultaneously, and the damage can occur slowly over many years. The process is usually painless.
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Is Anybody Listening? The Kidney Patient's Role in Doctor/Patient Communication
The question is, "Doctor, can you hear me?" The answer is, "Patient, are you listening?"
This question and this answer are repeated hundreds of times a day as physicians and patients interact. The real question is: "Is anybody listening?" The real answer is: "Very few people are listening."
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KidneySchool.org: It Might Just Save Your Life! (Podcast)
Dori Schatell, Executive Director of the Medical Education Institute, visits KidneyTalk to talk with Lori and Stephen about the Institute's Kidney School (www.kidneyschool.org). No, it doesn't have a football team, and no cheerleaders (Stephen was so disappointed), but this online educational program for people with kidney disease consisting of 16 interactive modules of about 20 minutes each will tell you something that makes a difference in your life!
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Learn About Lupus (Podcast)
Did you know Lupus can lead to kidney disease? Wendy has taken on kidney disease, dialysis, and lupus with a positive attitude. In this show, she talks freely about her life and how chronic illness has affected her. She’s all about education. Listen in and educate yourself a little.
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Managing Stress: What Kidney Patients, Family Members, and Caregivers Need to Know
Trying to replace what kidneys used to do requires hemodialysis treatments three times a week, or daily exchanges for the peritoneal dialysis patient, or a renal transplant. But dialysis is just the beginning. There are daily medicines, dietary restrictions, fluid limitations, and financial burdens that accompany dialysis treatments. This can result in extreme emotional stress.
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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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Nephropathy
A complication of diabetes that damages the kidneys' ability to filter waste from the blood. Diabetic nephropathy is the single most common cause of kidney failure in the Western world. Nearly one-third of all people with Type 1 diabetes will eventually develop kidney failure due to diabetic nephropathy. A small percentage of people with Type 2 diabetes will also eventually develop diabetic nephropathy.
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Phosphorous: What is it and Why is it Important?
Phosphorus is a major mineral found throughout the body. Phosphorus is controlled as part of normal, healthy kidney function. When the kidneys do not work effectively, the level of phosphorus accumulates in the body. Your dialysis clinic measures the amount of phosphorus in your blood during the monthly laboratory tests
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PKD: It Runs in the Family (Podcast)
With a family history of PKD - many of her family members have not made it past their 50th birthday - Linda Oakford made two life-affecting decisions in her early 20s which actually helped her meet her husband! This is an inspirational story of courage, of selflessness, and strategizing to life’s realities while finding the silver lining. Tune in for hope and courage now.
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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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Proteinuria
The presence of protein in the urine, an early sign of kidney disease. One of the major medical complications of diabetes is diabetic nephropathy, a type of kidney disease that develops slowly over the course of years. Diabetic nephropathy can lead to end-stage renal disease (kidney failure), necessitating dialysis or kidney transplantation. In fact, diabetic nephropathy is the leading cause of kidney failure in the United States.
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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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Sleep Apnea and Kidney Disease
Sleep apnea (SA) is a serious condition that is particularly important for patients with kidney disease to identify and understand. Complications include hypertension, heart attacks, strokes, and even sudden death. Just as importantly, SA affects individuals on a daily basis, causing fatigue, headaches, depression, and overall diminished executive functioning, which can lead to strains on interpersonal relationships and loss of productivity in daily endeavors.
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Slip, Slop, Slap- Preventing Harmful Effects of the Sun
Warnings about the damaging effects of the sun’s ultraviolet (UV) rays on the skin have been at the forefront of health advice for years. As a kidney transplant recipient, I know that the chance of getting skin cancer is much higher for me than for the rest of the population.
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Summer Grilling Tips & Techniques
Grilling is not just for the summertime! I grill all year round as a low-fat way to prepare chicken, meat, fish, or vegetables. Grilling is easy; there are no pots or pans to clean and it’s a great way to entertain. Read on to learn more about preparing some foods for grilling and tips on grilling to perfection.
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Take Charge and Lengthen Your Life
Are you aware that some patients live and enjoy life for 10, 20, even 30 years and longer while on hemodialysis? One of my good friends has been on hemodialysis for 33 years! On the other hand, far too many patients develop problems that curtail long life.
What makes the difference?
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Ten Transplant Tips
Having a transplant can be a wonderful experience, but as in all aspects of treatment you must do your part. What is your part, you ask? Let’s look at the top ten things that you need to know to be successful with a kidney transplant.
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Thanksgiving - Indulging Can Be Hazardous
Thanksgiving is almost here. We will gather with family and friends and share a tasty meal. For most people, it is a happy occasion. However, some people dread the festive feast. Many people who live with chronic kidney disease have dietary restrictions that don’t coincide with the culinary delights of the holiday season. The dialysis diet can be difficult to adhere to during the holidays, so it is important to make sure your holiday meal is healthy. And remember many family members may be dealing with their own dietary restrictions.
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The Evaluation and Process of a Kidney Transplant
Anyone who is in or has kidney failure is a potential candidate for a renal transplant. Yet, it's important to know that the procedure comes with both advantages and disadvantages, and it may not be a good choice for everyone.
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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 Importance of Oxygen During Hemodialysis
While dialysis patients know that their treatment sessions can be annoying, painful, scary, and draining, they are also aware that they are a lifesaving necessity. Dialysis is work, and work requires energy. Energy requires fuel.
A large amount of energy is necessary for excess water and poisons to move out of our body’s cells and into the tissue fluid, blood, and dialyzer. Each cell in the body has a "powerhouse" called the mitochondria which needs "fuel" to run. Oxygen is the fuel for the "powerhouse" of the cell. (Oxygen isn't everything, but it's right up there with money!)
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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 - 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 Protein Challenge: Myth or Fact?
Proteins supply amino acids. Amino acids are "building blocks" that build, repair, and maintain your body tissues. Your body uses protein to:
Make enzymes, hormones, and other body chemicals;
Carry nutrients;
Make muscles contract; and
Regulate body processes.
Read on to see how "protein savvy" you are...
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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 Truth About Protein
People who have been diagnosed with chronic kidney disease (CKD) often find themselves confronted with many lifestyle changes, with diet being one of the most challenging. But there are steps that can be taken to help delay the start of dialysis. This article briefly reviews the components of a CKD diet with the primary goal to maintain optimal nutrition. There is no “one-size-fits-all” diet. Your diet needs to be individualized based on your kidney function, other medical conditions, and nutritional status.
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Transplant Website Review
Today's feature site is US Transplant, at www.ustransplant.org. I've been a huge fan of this particular site for many, many years, as it gives volumes of center specific information as well as nationwide stats. I reference it frequently for data that I need to gather for lectures, 1:1 talks with patients regarding their particular situation as well as to just stay current on transplant statistical information. There are areas to check national stats, local hospital & OPO stats and research resources.
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Understanding Your Monthly Dialysis Lab Values
Laboratory values are only one of many ways that your healthcare is monitored. These values, like many aspects of kidney care, have clinical guidelines and standards for care that have been analyzed and recommended by experts
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Vitamin D and CKD
It's seems that everyone is talking about vitamin D and for a good reason. Long winter months indoors and use of heavy sunscreen are some of the reasons that keep our bodies from absorbing the UV rays necessary to make healthy amounts of vitamin D leading to vitamin D deficiency. But for people with chronic kidney disease, it's not just an issue of vitamin D deficiency but a deficiency in active vitamin D as well.
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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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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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Why We Crave Comfort Foods?
Everyone should feel free to enjoy comfort foods. You don't have to give them up completely, if you are on dialysis. Here's the trick: if they are eaten only on an occasional basis, no harm is done. But if large portions of these foods are frequently eaten, they contribute to excessive fluid gains, high blood pressure, high phosphorus or high potassium levels.
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