Hemodialysis and You.
Everything you want to know:
"What do my kidneys do?"
- Kidneys keep your blood pressure normal, balance water, and clean your blood.
- Your kidneys tell your body to keep good things and release what the body doesn't need (waste).
- They also play a role in making red blood cells and activate vitamin D (Pellico, 2013).
"Why do I need Hemodialysis?"
When the kidneys cannot do their job(s) over a longer period of time, you may develop Chronic kidney disease (CKD). Diabetes makes you more likely to develop CKD, because the kidneys have to work harder to stay balanced.
With Chronic kidney disease, there are different stages.
The stage of CKD depends on how well or how poorly the kidneys are doing their job; this is measured by GFR (glomerular filtration rate).
Normal GFR is from 120 to 130 mL/min.
- Stage 1: GFR >or= to 90
- Stage 2: GFR 60-89
- Stage 3: GFR: 30-59
- Stage 4: GFR; 15-29
- Stage 5: Kidney (renal) Failure, GFR <15
(Pellico, 2013).
Chronic renal (kidney) disease can become renal (kidney) failure when treatment with medications and special diet do not help.
Chronic Renal Failure means your kidneys are not working as they should (GFR less than 15) and waste can build up your blood; this can be dangerous and even cause death.The disease cannot be cured, but failure can be treated with Hemodialysis.
"Hemodialysis is a fancy word, but what does it mean?"
- Hemo= Blood
- Dialysis= Separate/remove waste and water
- Hemodialysis uses a machine (dialyzer) that acts like an extra kidney to remove waste keep the blood balanced and clean.
"How does it work?"
Ways Hemodialysis helps the body:
-Removes wastes
-Removes extra water
-Returns clean body to body
"How much time will it take?"
-Occurs three times a week
-May take 3-5 hours
Preparation
- Seek Support from others, and discuss future plans.
- Make sure your doctor knows what medications you are taking (including any cardiac medications or over-the-counter or herbal/natural remedies).
- Heparin: a medication that is given to prevent the blood from clotting during dialysis
- There are different ways to access to bloodstream for dialysis: these include
-Temporary device
-Fistula
-Graft
- Be sure to follow proper diet and limit fluids.
Treatment
- Blood exits body through a tube, goes through dialysis machine (artificial kidney), and is returned to the body, clean.
- Can be done at home or at a facility. Learn what is best for you.
-Home dialysis with assistance.
-Home must be checked and safe/suitable for dialysis.
-You may only need to report to dialysis center monthly
Managing Diabetes and Kidney Disease
Food glorious food. "What can I eat?"
Nobody likes following a diet!
However...
Guidelines are in place to promote safety for you as you begin your Hemodialysis Treatment, so It is important to follow these as closely as possible. This will decrease the chances of fluid overload and further uremia (or toxic buildup of waste normally filtered by kidneys), and other life-threatening conditions.http://www.diabetesforecast.org/2012/mar/kind-to-kidneys-meal-planning.html
Diabetic Diet
Changing your lifestyle for Diabetes and Kidney disease can be a hard adjustment, but there are many resources available to help.
Remember:
- Follow low-carbohydrate diet
http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/?loc=ContentPage-lwt1d
- Take prescribed medications
- Check blood sugars
(NIDDK, 2016), (ADA, 2016).
Renal (Kidney Friendly) Diet
Decrease...
Protein intake (Stick to good sources: Eggs, soy, meat, milk, poultry, fish)
- 1.2-1.3 g/kg/day
Sodium (Salt) Intake (Don't add extra)
- 2-3 g/day
Fluid Intake (This includes ice)
- Equal to daily urine output plus 500-800 mL
(Pellico, 2013)
Who can I talk to if I have questions about my diet?
- Talk to your provider...
- A registered dietician, R. D., is always the best resource for dietary information.
Safety Tips for You!
- If you have a fistula or graft, it should be checked for its normal vibrating or buzzing sound called a thrill. You should call your doctor if this is absent.
- Call doctor if you experience the following for more than 2 days:
"Itching, Trouble sleeping, Diarrhea or constipation, Nausea or vomiting, Drowsiness, confusion, or problems concentrating (NIH, USLM, 2016). "
- Avoid compression (putting pressure on) the site (no blood pressures/tight clothing)
- Blood to be drawn or IV inserted into the fistula= No thank you.
- Redness, swelling, bleeding, drainage, heat, or pain at site?=Call the Doctor (Pellico, 2013).
Lab Values to Know About While on Dialysis
- Ask provider to check your blood pressure (diabetes and decreased kidney function can cause heart complications)
- BUN (20-80), URR (65%), Kt/V (1.2), Blood values.
- Nutrition-related: A1C, albumin (greater than 4), potassium (3.5-5), calcium (8.0-10), Phosphorus (3-5), PTH 150-600.
Exercise and Activity
There are options to stay active while on Hemodialysis. Check them out here!
Resource for Support for You and Your Loved Ones
References
- Pellico, L. H. (2013). Focus on adult health: Medical-surgical nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
- American Diabetes Association. (n.d.). Retrieved April 04, 2016, from http://www.diabetes.org/
- American Diabetes Association. (n.d.). Retrieved April 04, 2016, from http://www.diabetes.org/
Kind-to-Kidneys Meal Planning. (n.d.). Retrieved April 03, 2016, from http://www.diabetesforecast.org/2012/mar/kind-to-kidneys-meal-planning.html