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Questions and Answers About Your Health

The Importance of Getting Your Catheter Removed

Question:

I have a catheter.  My doctor wants me to change to another kind of access for dialysis.  Why?

Answer:

Sometimes catheters are the only access that can be used for dialysis, after all other possibilities have been exhausted.  However, if this is not the case, then it is imperative that the catheter be removed.  The short version is that catheters cause more hospitalizations due to infection and cause higher death rates.
 
Patients who have catheters generally have about 4 hospitalizations per year, due to severe infection.  And there is more than double the probability of early death.  Only about 2-3% of patients should have catheters in place because all other access possibilities have been eliminated.  If you are using a catheter simply because it is convenient or you don't want to be stuck with a needle, you need to be fully aware of the dangers and the poor outcomes you will likely have.
 
If you have a catheter, you should tell your doctor that you want another kind of access and to have the catheter removed.

The Importance of Time on Each Dialysis Session

Question:

Even though my Kt/V is OK, my doctor wants me to have more time on dialysis. Why?

Answer:

Recent scientific studies have shown that just attaining a sufficient quantity of toxin removal (Kt/V) is simply not enough. Kt/V does not measure the amount of salt and water removed.  It is very difficult to remove the correct amount of fluid in the body in less than 4 hours. Therefore, there are enormous efforts by the medical community to increase the time of each dialysis session.

Leaving excess fluid and gaining excess fluid between each dialysis session is associated with an enlarged heart, repeated hospitalization and sudden death. In fact, it is the most common reason for repeated hospitalizations and is the greatest cause of death in a patient undergoing dialysis.

Therefore, even if your doctor has not prescribed more time, you should ask him for this. Though inconvenient, it allows a smoother dialysis session and greater length of life. 

The Importance of Good Foot Care

Question:

I was recently diagnosed with diabetes and my doctor told me that it’s important to take special care of my feet. Why?

Answer:

Vascular disease and diabetes can lead to many kinds of foot problems.  For some strange reason, we don’t like to talk about feet, we like to cover them up and not mention them to our doctors and nurses.  Perhaps the reason is that we can’t see our feet very well or because of nerve problems we don’t feel pain from developing complications.

Foot problems may be as common as athlete’s foot, or more complicated such as bunions and calluses, but as severe as superficial and especially deep and infected ulcers.  Unattended, this could even lead to amputation.  View Renal Ventures’ Foot Care for Everyone pamphlet for things to be aware of and watch for as well as proper foot care.

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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