Ten reasons for choosing Home Dialysis.
.Convenience
.Efficient and effective
.Cost saving
.Enhanced family participation
.Enhanced patient participation
.More liberal food intake.
.Less fluid restriction.
.improved phosphate control
.Longer duration of residual renal function
.A more physiological approach to renal replacement therapy.
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The options available to patients with end stage renal disease have increased over the last few years
Although In-center hemodialysis remains the predominant choice of most patients, there is now an increasing percentage of patients who are interested in the home modalities. As a result the percentage of patients on peritoneal dialysis (chronic ambulatory peritoneal dialysis, cycler assisted peritoneal dialysis or combination of both) and home hemodialysis have increased. However a number of patients are unable to benefit from this treatment modalities due to some limitations at home.
Thus in-center nocturnal hemodialysis becomes a viable option for those patients that could benefit from prolonged and gentle hemodialysis under the supervision of the dialysis team. In this scenario the patient shows up for dialysis at between 8.00 p.m. and 9.00 p.m. and is on the machine for between six to eight hours depending on the prescription. During the treatment period, privacy is maintained by proper spacing and a universal lights out policy is in effect at about 10.30.p.m.
The benefits of this variant of hemodialysis include better fluid management, better blood pressure control, better energy level and better phosphate control.
My experience so far with this modality has been interesting and I always offer it to patients that I think will benefit from longer, and gentler form of hemodialysis.
The recently concluded Davita Home Modality University was quite a remarkable success.
The presentations were concise and straight to the point.
Part of the take home from the meeting is the growing recognition and awareness of the usefulness of all forms of home modalities as alternative to conventional in-center hemodialysis.
The cost saving compared to conventional in-center dialysis is quite substantial.
The quality of life and life expectancy on peritoneal dialysis is comparable if not superior to conventional hemodialysis.
It is therefore advisable that patients with chronic kidney disease be exposed to the different forms of home therapy early in the course of the conversation.
This will enable the patient and supporting family members get the necesary knowledge needed to make an informed decision.
This is the first in a series on Home Modality to follow.
Watch out.
After your annual physical examination, there are certain numbers of which are of significance with regards to the health of your kidneys.
It is important to be familiar with some of these numbers and what the normal ranges are.
1. Estimated GFR number. This is a measure of your kidney function and above 60 is considered normal. Below 60 will require more investigations as to the etiology of the decrease capacity of the kidneys.
2. Blood pressure reading. High blood leads to kidney disease, heart disease and strokes. The normal blood pressure reading is 120/80.
Any reading above 140 in the upper number and above 90 in the lower number is indicative of high blood pressure and deserves some form of targeted intervention.
3. Albumin to creatinine ratio. This estimates the amount of protein in your urine per day.
A value above 30 on two occasions is indicative of underlying kidney disease and warrants to be carefully investigated and treated if needed.
4. Total cholesterol; Total cholesterol value above 200 is high and puts you at risk for heart disease. In addition the Low density cholesterol (bad cholesterol) should be below 100 especially in those with diabetes or pre-existing heart disease.
5. Blood Glucose check: This assesses your risk for diabetes mellitus which is the leading cause of kidney failure.
A fasting level above 125 and 2 hours after eating over 200 is indicative of diabetes mellitus.
These are some of the test results that you need to be familiar with so that your next annual physical examination is more rewarding to you.
Expect more information regarding your kidney health to follow.
Over the last several years, the medical community and indeed the third party payers including Health and Human services have come to realize the increasing number and cost of caring for individuals with chronic kidney disease.
So it is important to understand first and foremost the role of the kidneys in our day to day life.
The kidneys regulate the body fluid levels, filters waste products and toxins from the blood, keep the blood electrolytes(sodium, potassium, phosphorus etc) in balance, release a hormone that is essential in regulating blood pressure, activate vitamin D to maintain healthy bones and release erthropoetin which is needed for production of red blood cells.
The main risk factors for chronic kidney disease in the society include a personal or family history of diabetes mellitus, hypertension, cardiovascular disease as well as a family history of renal diseases. Racial differences however exist.
Additional risk factors include the prolonged and unsupervised use of non-steroidal agents, nephrolithiasis(kidney stones), obesity and autoimmune disorders such as lupus etc.
Most people with chronic kidney disease have no symptoms early in the course of the disease so some of the signs one should watch out for include fatigue and weakness, foamy urination which may indicate excess amount of protein in the urine, blood in the urine or dark urine, puffy eyes and swelling of the face, hands,ankles and feet. Of course a decrease in urination should immediately demand a medical check up.
Increased thirst and increase need to urinate at night should warrant the need to be tested for diabetes mellitus.
It is important to know if you have chronic kidney disease because of the potential problems that it could lead to if undetected. These include Heart attack and stroke, difficult to control blood pressure, anemia, weak bones, nerve damage(neuropathy) and of course end stage renal disease.
End stage renal disease is best managed by the many modalities of renal replacement therapy available. The mainstay of management of end stage renal disease is dialysis or tranplantation. Dialysis could be in-center or home hemodialysis, chronic ambulatory peritoneal dialysis and cycler assisted peritoneal dialysis. There are also other variations of the above modalities depending on the preference of the patient and the family.
It is much better to find out earlier about the risk of developing chronic kidney disease before reaching end stage renal disease. This way one can prevent or slow the progression to end stage renal disease and continue to lead a healthy and productive life.
Hello everyone,
Today I am going to provide a number of reasons that one might be at risk for developing high blood pressure.
Hypertension is quite prevalent in the society as close to 50 million Americans suffer from the condition.
For the most part, the cause is unknown and is thus labelled as essential hypertension.
However the following factors might increase your risk of developing hypertension.
.Race: People of African descent tend to have high blood pressure more often than those of caucasian origin.
.Age: The incidence of high blood pressure increases with age.
.Obesity: Folks who are overweight have a greater propensity to develop high bllod pressure.
.Heredity: Hypertension tends to run in families so knowing your family history is beneficiary in this regards.
.Exercise: Inactive or sedentary lifestyle may result in obesity which will increase your risk of developing high blood pressure.
.Diet: Excessive use of salt may increase your risk of developing high blood pressure. Every attempt should be made to restrict your salt intake especially if you are at risk of developing high blood pressure.
.Alcohol : Excessive consumption of alcoholic beverages may increase your risk of developing high blood pressure.
.Smoking: Smoking and hypertension will increase your risk of developing cardio-vascular complications including strokes and heart attacks.etc.
.Oral contraceptives: Women who use oral contraceptive pills and smoke are at increased risk of developing high blood pressure and other complications such as blood clot etc.
.Gender gap: Hypertension is more common in men before the age of 45;, equal between the ages of 45 and 54 and more in women after the age of 54.
Above are some of the risk factors associated with developing high blood pressure.
Next time I will dwell more of the relationship between hypertension and chronic kidney disease.
Remember to always consult with your healthcare provider when in doubt.
Hypertension remain a major cause of kidney disease in the general population,
Its effect is more pronounced in those of African descent.
The causes are multi-factorial and include genetic as well as environmental factors.
It is important for adults to have their blood pressure checked by a medical personnel atleast once a year and
thereafter as per the advice of your physician.
Combating obesity and striving to remain an the ideal body weight will help to control, prevent or curtail your risk of developing high blood pressure.
Regular exercise three to four times a week is helpful in maintaining your blood preesure.
Diet low in salt and with appropriate composition of carbs, protein and fat is essential in maintaining your ideal blood pressure.
The ideal blood pressure is a systolic blood pressure less than 130mmHg and a diastolic blood pressure less than 85mmHg.
More specifics to follow.
This is a new blog dedicated to providing information and updates on medical issues of interest to me.
The focus will be on kidney related ailments.
I hope that you will find my blogs informative, educational and simple to follow.
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