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Questions and Answers About Your Health

The Importance of finding out if Home Dialysis is an option.

Question:

Is Home Dialysis an option for me?

Answer:

Home Dialysis – CAPD (Continuous Ambulatory Peritoneal Dialysis), CCPD (Continuous Cycler Peritoneal Dialysis) and HHD (Home Hemodialysis) all offer advantages to the patient because the patient can perform their treatments at home.  You are able to schedule your treatments around work or family responsibilities and can schedule additional treatments if needed.  Peritoneal dialysis will require a permanent catheter be inserted in your abdomen for instillation and draining of fluid.   Hemodialysis will require creation of a fistula which will allow for blood to flow through the hemodialysis machine.  Both procedures are considered same day surgery.

One advantage is no travel three times weekly to the dialysis center and this is important for patients who may live in a rural location hours away from a center,  be employed or family needs.   You will still be required to visit the clinic once monthly for review of your treatments, medications and see your doctor.  Additionally, your nurse or doctors are just a phone call away to answer questions if needed.

You (and partner for home hemo) will have to spend several weeks at the clinic being trained to perform the treatment for several hours at a time.  The home training nurse will be with you during the training sessions to ensure you are learning how to do the procedure correctly and safely.  You can expect reading materials, written tests and actual treatments while you are there.  Our home team will be required to make a home visit before you start training and periodically thereafter to ensure your treatments are going well.

The best way to determine if home dialysis is for you is to talk to your doctor and meet with the home training nurse in your unit.  They can show you films and books providing information on all modalities and answer any questions you may have so you can make an informed decision.

The Importance of Getting on the Kidney Transplant List

Question:

I have been told that now that I am on dialysis it is important to get on the transplant list.  How do I go about doing that?

Answer:

If you have chronic kidney disease or renal failure, you may be eligible for a kidney transplant. Tell your Nephrologist or someone at your dialysis center that you would like to have a kidney transplant. If approved by your doctor, you will be referred to a transplant center. 

Someone from the dialysis center will assist you with finding a transplant center that is covered by your insurance.  Once you visit the transplant center, you will undergo a vigorous medical examination to ensure you are healthy enough to undergo transplant surgery.  Once you have your examination and have been approved for transplant you will be placed on the Kidney Transplant List to await a kidney. 

You can expedite getting a healthy kidney by speaking with relatives and friends to see if they would be willing to donate a kidney to you.  Your transplant center will provide educational materials to help you through this process.

The Importance of knowing what Peritoneal Dialysis is.

Question:

While talking with another patient during my Hemodialysis treatment, he indicated he is considering Peritoneal Dialysis. What is Peritoneal Dialysis?

Answer:

Peritoneal Dialysis, commonly referred to as PD, is a type of dialysis done in the convenience of your home. Unlike Hemodialysis, PD utilizes the peritoneum membrane in your belly to perform dialysis. A small flexible catheter is inserted into the peritoneum, the lining of your belly.  Dialysate enters your body through this catheter and dwells for several hours; then is drained out of the body through the same catheter.  This process can be done manually during the day or most commonly, at night while you sleep. There is no blood exchange or needles for this process.

Because it is performed daily, “peritoneal dialysis is a continuous process of removing excess fluid and toxic material from the body, mimicking the work of native kidneys. This property of peritoneal dialysis allows patients to be less restricted in their food and fluid intake.”

The Importance of Dry Weight

Question:

I’m told that I am above my dry weight.  What does that mean?

Answer:

Normal kidneys keep the amount of fluid in our bodies regulated appropriately.  As we lose kidney function, sometimes diuretics are needed to further regulate it.  But when we are on dialysis, the machine has to remove the fluid.  Your physician and nurse will attempt to ascertain what weight you have at the right amount of fluid.  Most dialysis patients carry too much fluid, really salt and water.  The consequences of this are high blood pressure, heart enlargement and early death.  Therefore it is important to get the “dry weight” correct.

Taking in too much salt, which makes you want to drink more fluid, makes the dry weight go up.  The dialysis machine then has to take that excess fluid off, sometimes causes low pressure and cramps during dialysis.  The best way to assure attaining a dry weight with ease is to eat little salt and gain less weight. 

If you are taking multiple blood pressure medications, clearly your dry weight is too high.  You might talk to your doctor about reducing the medications and reducing your dry weight.

The Importance of the New Dialysis Reimbursement Program

Question:

I have been hearing about the new reimbursement method that Medicare is using to pay for my dialysis.  How will this affect me?

Answer:

Beginning January 1, 2011, Medicare will change the way it pays for dialysis services.  As a patient of Renal Ventures clinics, you will receive a letter that explains this.  Essentially certain services, labs and drugs, that previously the dialysis facility billed to Medicare separately, will all now be “bundled” into one lump payment.

There are several things that are important for you.

The foremost has to do with the quality of your care. Quality of care will not change and, if it does, it will likely get better.  The regulations include requirements that certain quality measures be maintained.  Renal Ventures has always excelled in this area.  Our quality outcomes for the facility and patients have always been better than regulations require.

We have worked closely with experts and advisors to develop new protocols that will assure this quality.  We have been traveling to each facility to educate staff and physicians.  They have endorsed the changes and agree that there will be no compromise with regards to your care.

If you are a Renal Ventures patient, look for the letter to explain things in more detail.

Do you have a question for our Experts? Submit a Question via email. Questions will be reviewed by a team of Renal Ventures medical professionals on a regular basis. Not all questions may be answered on the site, but we will try to respond in a timely manner.

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