Sunday, June 19, 2011
Topics will include:
Advancements in Transplantations: The patients perspective
Feeling Fit and Fabulous
Finding and keeping romance alive
~~~~~~~~COMPLIMENTARY BRUNCH AVAILABLE~~~~~~~~
Please register by July 5th
online at rsnhope.org
Friday, June 17, 2011
What You Need
to Know About
A urinalysis is a simple, inexpensive test that can
help to detect problems in many parts of your
body including your kidneys and urinary tract, your
heart and your liver. A urinalysis can help to detect
many diseases before symptoms occur. Early detection
and treatment can often prevent serious diseases
from getting worse. More than 20 million
Americans—one in nine adults—have chronic kidney
disease, and most don’t even know it. More
than 20 million others are at increased risk for
chronic kidney disease. Yet, a urinalysis can detect
protein in the urine—one of the earliest signs of
kidney disease—years before symptoms appear
and at a time when treatment can make all the
What is a urinalysis?
A urinalysis is an examination of a sample of
urine that can help find medical problems like
kidney disease, diabetes, liver disease and urinary
Who should have a urinalysis?
Everyone should have a urinalysis as a child and
then periodically as an adult. It’s especially important
for people who have an increased risk for kidney
disease to be tested for protein in their urine.
This is included in a urinalysis. Persistent protein in
the urine (two positive tests for protein over several
weeks) is one of the earliest signs of chronic kidney
disease. You may be at increased risk for kidney
disease if you:
❖ have diabetes
❖ have high blood pressure
❖ have a family history of chronic
❖ are an older adult
❖ are an African American, Hispanic
American, Asian or Pacific Islander or
If you have any of these risk factors, or think you
may be at increased risk for chronic kidney disease,
speak to your doctor about having a urinalysis.
What does a urinalysis include?
A urinalysis has three parts:
1. Visual examination of the urine sample for
color and clearness. Blood may make urine look
red or the color of tea or cola. An infection may
make urine look cloudy.
2. A dipstick examination, which uses a chemically
treated strip to check for the following:
❖ pH is a measure of the amount of acid in the
urine. An abnormal pH may be a sign of kidney
stones, urinary infections, chronic kidney
disease or certain disorders that affect growth
and development in children.
❖ Protein is an important building block in the
body. When your kidneys are damaged, protein
leaks into your urine. Persistent protein inprotein in the urine suggests that the kidney’s filtering
units have been damaged by chronic kidney disease.
❖ Urine Creatinine gives an estimate of the
concentration of your urine, which allows for
a more accurate protein result. Creatinine is a
by-product of normal muscle activity, which is
found in the urine and blood.
❖ Glucose (sugar) is usually a sign of diabetes.
In children, sugar in the urine may sometimes
be related to a disorder that affects growth
❖ Bacteria and white blood cells (pus cells) are
signs of infection. Bacteria without white
blood cells may suggest another type of problem
such as vaginal or bladder disease.
❖ Bilirubin is a waste product from the breakdown
of old red blood cells. It is normally
removed from the blood by the liver and
becomes part of bile. Its presence in the urine
may be a sign of a liver disease.
3. Urinalysis also includes examining a small amount
of urine under a microscope. Some of the things
that may be seen include:
❖ Red blood cells, which may be a sign of kidney
diseases that damage the filtering units of
the kidneys, allowing blood cells to leak into
the urine. Blood in the urine may also be a
sign of problems like kidney stones,
infections, bladder cancer or a blood disorder
like sickle cell disease. While enough
blood may be present to cause a color
change you can see, blood in the urine is
usually so small that a microscope is needed
to see it.
❖ White blood cells (or pus cells), which are a
sign of an infection or inflammation in the
kidneys, bladder or another area.
❖ Bacteria, or germs, which are usually a sign
of an infection in the body.
❖ Casts, which are tube-shaped forms made
of protein, and may have red or white blood
cells or other cells inside. Casts form in certain
kidney diseases because the kidneys are
releasing a sticky type of protein that traps
blood cells and other types of cells.
❖ Crystals, which are formed from chemicals
in the urine. If they become large enough,
they form kidney stones.
How is a urinalysis done?
Your urine is collected in a clean specimen cup.
Some of the urine sample is tested right away with
a dipstick. The rest is placed in a test tube and
spun before being checked under the microscope.
Only a small amount of your urine is needed
(about 2 tablespoonfuls) to do the test. If possible,
your morning urine is the best, but a random
sample can also be used. The urine should be as
fresh as possible and, therefore, should not be
brought from home.
Can any drugs or vitamins
affect my results?
Yes, many drugs and vitamins can affect the urinalysis.
For example, vitamin C pills, antibiotics and
certain drugs used to treat Parkinson’s disease
could cause you to have a “false” positive result,
and you may need to have other tests to confirm
your result. Make sure to tell your doctor or clinic
staff about all the medications and vitamins
you take. Fever and heavy exercise can also give
Is a urinalysis expensive?
How long does it take to get
A urinalysis is a simple, inexpensive test. Most
insurance carriers cover part or all of a urinalysis
test. A urinalysis can be done right in your doctor’s
office. The test takes only about 5 to 10
minutes to do, and you can discuss your results
with your doctor right away. A urinalysis can also
be done in a laboratory.
What does it mean if my urine
test shows protein and/or blood?
You may have kidney or urinary tract disease,
but your doctor will need to confirm this.
Persistent protein in the urine (two positive results
over several weeks) is a sign of chronic kidney disease.
Your doctor may do the following tests to
confirm your diagnosis, check your kidney function
and help plan your treatment:
❖ A simple test for creatinine in your blood,
which can be used to estimate how much kidney
function you have (see glomerular filtration
rate). Creatinine is a by-product that comes
from normal muscle activity. When your kidneys
are damaged, your blood creatinine level may
build to a high level.
❖ Glomerular filtration rate (GFR), which tells
your doctor how much kidney function you
have. You do not need another test to check
your GFR. Your doctor can calculate your GFR
from your blood creatinine test, your age, gender
and body size. Your GFR is the best way to
track your kidney function.
❖ An ultrasound or CT scan, which gives your
doctor a picture of your kidneys and urinary
tract. This shows whether your kidneys are too
small or too large or have kidney stones,
tumors or other problems.
❖ A kidney biopsy, which is done in some cases
to help identify a specific type of kidney disease
and see how much kidney damage has
occurred. To do the biopsy, the doctor removes
small pieces of kidney tissue and looks at them
under a microscope.
If my tests show kidney or
urinary tract disease, what treatment
will I need?
Your treatment plan is based on the type of kidney
or urinary tract disease you have, your level of kidney
function and other health problems you may
have. Some diseases can be treated with medications.
Others could require surgery. If severe kidney
disease is found, dialysis or a kidney trans-plant
may be needed.
Can treatment prevent
chronic kidney disease from getting
Yes. In many cases, early detection and treatment
may keep chronic kidney disease from getting
How can a urinalysis
help to detect early signs of
Studies show that people who have protein in
their urine have an increased chance of developing
heart disease as well as kidney disease. Many
health problems that affect the kidneys, such as
diabetes and high blood pressure, also affect the
heart and blood vessels. Protein in the urine may
be a sign that the blood vessels have already been
damaged by these diseases, and organs such as
the heart and kidneys have been affected.
This brochure was supported by an educational grant from
National Kidney Foundation
30 East 33rd Street
New York, NY 10016
© 2002 National Kidney Foundation, Inc.
All Rights Reserved. No part of this publication may be reproduced or transmitted
in any form or by any means, electronic or mechanical, includ-ing
photocopy, recording or any information storage and retrieval system, without
permission in writing from the National Kidney Foundation, Inc.
K/DOQI Learning System (KLS)TM
Bayer Part No. 0351033
Monday, June 13, 2011
Nutrition and HemodialysisNow that you are beginning hemodialysis, there may be many changes in your daily life. Your doctor has probably told you that you may need to make some changes in your diet. The renal dietitian at your dialysis center will help you plan a diet for your special needs.
Why do I need to be on a special diet?Because your kidneys are not able to get rid of enough waste products and fluids from your blood and your body now has special needs, you will need to limit fluids and change your intake of certain foods in your diet. How well you feel will depend on:
- eating the right kind and amounts of food from your diet
- having the hemodialysis treatments your doctor orders for you
- taking the medications your doctor orders for you.
How will I know if I am eating right to keep me healthy?Because you are on dialysis, you have some very special needs. Eating well helps you stay healthy. Eating poorly can increase your risk of illness. Your dietitian will talk with you about how well you are eating.
Some questions you might be asked:
- Have you noticed a change in the kind or amount of food you eat each day?
- Have you had any problems eating your usual or recommended diet?
- Have you lost weight without trying?
- Have you noticed any changes in your strength or ability to take care of yourself?
Some special blood tests that are done each month are called Kt/V (pronounced kay tee over vee) or urea reduction ratio (URR). These tests help your doctor decide if you are getting enough dialysis. Getting the right amount of dialysis is important to help you feel your best.
A change in your fat and muscle stores or any of these blood tests could be a sign that you are not getting enough dialysis. Along with the Kt/V, these tests provide information about your intake of protein or your protein equivalent of nitrogen appearance (PNA). Using the PNA, your albumin and any changes in your appetite, your dietitian will determine if you are eating enough of the right foods. The right amount of dialysis is needed to make sure you are able to enjoy your food while keeping you healthy.
What if I have high cholesterolChanging your diet may help lower the cholesterol level in your blood. Your dietitian will talk with you about the kinds of fat and animal foods you eat. Also, your doctor may decide you need a special medication to reduce the cholesterol in your blood.
What if I have diabetesIn some cases, you may need to make only a few changes in your diet to fit your needs as a kidney patient. For example, some of the free foods you have been using may need to be limited on your kidney diet. Your dietitian will help develop a meal plan especially for you.
Is there anything else I should knowThe following important tips can be helpful with your diet:
- Fresh or plain frozen vegetables contain no added salt. Drain all the cooking fluid before serving.
- Canned fruits usually contain less potassium than fresh fruits. Drain all the fluid before serving.
- Non-dairy creamers are low in phosphorus and can be used in place of milk.
- Labels on food packages will give you information about some of the ingredients that may not be allowed in your diet. Learn to read these labels.
- To help you avoid salt, many herbs and spices can be used to make your diet more interesting. Check with your dietitian for a list of these.
Sunday, June 12, 2011
Wednesday, June 8, 2011
Filtering Dialysis Myths from FactsMyth: The only option for receiving dialysis treatment is to travel to a center at least three times per week for hours at a time.
Fact: Dialysis can be done in many ways: You can do hemo-dialysis which is done in a dialysis unit, a hospital or in the comfort of your own home. Or, you can do peritoneal dialysis which is done in your home. You and your doctor decide which form of dialysis and place is best for you, and based on your medical condition and your wishes.
Myth: Dialysis is painful.
Fact: Depending on the form of dialysis you choose, if you are on hemo-dialysis you may have some discomfort when the needles are put into your fistula or graft, but most patients usually have no other problems. The dialysis treatment itself is painless. However, some patients may have a drop in their blood pressure that could lead to nausea, vomiting, headaches or cramps. However, if you take care to follow your kidney diet and fluid restrictions these types of side effects can be avoided.
Myth: Dialysis is a death sentence. Fact: No, dialysis is a life sentence. When you, your family and doctor decide that it is time for you to undergo dialysis what you all are saying is that you want to live your life and feel better.
Myth: Dialysis is expensive or unaffordable for the normal patient. Fact: The federal government pays 80 percent of all dialysis costs for most patients. Private health insurance or state medical aid also helps with the costs.
Myth: Due to time constraints and exhaustion, dialysis patients can’t travel. Fact: Dialysis centers are located in every part of the United States and in many foreign countries. The treatment is standardized. You must make an appointment for dialysis treatments at another center before you go. Your facility social worker can inform you about what you need to do. Regarding exhaustion, if you take care of yourself and follow your doctor’s recommendations you should feel fine.
Myth: Dialysis patients do not have the time or energy to work. Fact: Many dialysis patients can go back to work or school after they have gotten used to dialysis.
Myth: Dialysis patients have no say in their treatment. Fact: You as a patient have a great deal of control over your treatments. Patients have a bill of rights (http://www.kidney.org/atoz/pdf/DialysisBillRights.pdf) which includes quality care, privacy, medical information, social work and dietary counseling
Myth: As a dialysis patient, I will feel alone and will be a burden to my family Fact: Many dialysis patients, once they become accustomed to their dialysis treatments, actually start to feel much better than they did prior to starting dialysis and feel much less of a burden to their families. Also, many get involved in volunteer activities to help other people like themselves, for example participating in kidney awareness activities.
DialysisDialysis is a treatment that does some of the things done by healthy kidneys. It is needed when your own kidneys can no longer take care of your body's needs.
When is dialysis needed?You need dialysis when you develop end stage kidney failure --usually by the time you lose about 85 to 90 percent of your kidney function.
What does dialysis do?Like healthy kidneys, dialysis keeps your body in balance. Dialysis does the following:
- removes waste, salt and extra water to prevent them from building up in the body
- keeps a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate
- helps to control blood pressure
Is kidney failure permanent?Not always. Some kinds of acute kidney failure get better after treatment. In some cases of acute kidney failure, dialysis may only be needed for a short time until the kidneys get better.
In chronic or end stage kidney failure, your kidneys do not get better and you will need dialysis for the rest of your life. If your doctor says you are a candidate, you may choose to be placed on a waiting list for a new kidney.
Where is dialysis done?Dialysis can be done in a hospital, in a dialysis unit that is not part of a hospital, or at home. You and your doctor will decide which place is best, based on your medical condition and your wishes.
Are there different types of dialysis?Yes, there are two types of dialysis --hemodialysis and peritoneal dialysis.
What is hemodialysis?In hemodialysis, an artificial kidney (hemodialyzer) is used to remove waste and extra chemicals and fluid from your blood. To get your blood into the artificial kidney, the doctor needs to make an access (entrance) into your blood vessels. This is done by minor surgery to your arm or leg.
Sometimes, an access is made by joining an artery to a vein under your skin to make a bigger blood vessel called a fistula.
However, if your blood vessels are not adequate for a fistula, the doctor may use a soft plastic tube to join an artery and a vein under your skin. This is called a graft.
Occasionally, an access is made by means of a narrow plastic tube, called a catheter, which is inserted into a large vein in your neck. This type of access may be temporary, but is sometimes used for long-term treatment.
How long do hemodialysis treatments last?The time needed for your dialysis depends on:
- how well your kidneys work
- how much fluid weight you gain between treatments
- how much waste you have in your body
- how big you are
- the type of artificial kidney used
A type of hemodialysis called high-flux dialysis may take less time. You can speak to your doctor to see if this is an appropriate treatment for you.
What is peritoneal dialysis and how does it work?In this type of dialysis, your blood is cleaned inside your body. The doctor will do surgery to place a plastic tube called a catheter into your abdomen (belly) to make an access. During the treatment, your abdominal area (called the peritoneal cavity) is slowly filled with dialysate through the catheter. The blood stays in the arteries and veins that line your peritoneal cavity. Extra fluid and waste products are drawn out of your blood and into the dialysate. There are two major kinds of peritoneal dialysis.
What are the different kinds of peritoneal dialysis and how do they work?There are several kinds of peritoneal dialysis but two major ones are:
Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cycling Peritoneal Dialysis (CCPD).
Continuous Ambulatory Peritoneal Dialysis (CAPD) is the only type of peritoneal dialysis that is done without machines. You do this yourself, usually four or five times a day at home and/or at work. You put a bag of dialysate (about two quarts) into your peritoneal cavity through the catheter. The dialysate stays there for about four or five hours before it is drained back into the bag and thrown away. This is called an exchange. You use a new bag of dialysate each time you do an exchange. While the dialysate is in your peritoneal cavity, you can go about your usual activities at work, at school or at home.
Continuous Cycling Peritoneal Dialysis (CCPD) usually is done at home using a special machine called a cycler. This is similar to CAPD except that a number of cycles (exchanges) occur. Each cycle usually lasts 1-1/2 hours and exchanges are done throughout the night while you sleep.
Will dialysis help cure the kidney disease?No. Dialysis does some of the work of healthy kidneys, but it does not cure your kidney disease. You will need to have dialysis treatments for your whole life unless you are able to get a kidney transplant.
Is dialysis uncomfortable?You may have some discomfort when the needles are put into your fistula or graft, but most patients have no other problems. The dialysis treatment itself is painless. However, some patients may have a drop in their blood pressure. If this happens, you may feel sick to your stomach, vomit, have a headache or cramps. With frequent treatments, those problems usually go away.
How long has dialysis been available?Hemodialysis and peritoneal dialysis have been done since the mid 1940's. Dialysis, as a regular treatment, was begun in 1960 and is now a standard treatment all around the world. CAPD began in 1976. Thousands of patients have been helped by these treatments.
How long can you live on dialysis?We do not yet know how long patients on dialysis will live. We think that some dialysis patients may live as long as people without kidney failure.
Is dialysis expensive?Yes. Dialysis costs a lot of money. However, the federal government pays 80 percent of all dialysis costs for most patients. Private health insurance or state medical aid also help with the costs.
Do dialysis patients feel normal?Many patients live normal lives except for the time needed for treatments. Dialysis usually makes you feel better because it helps many of the problems caused by kidney failure. You and your family will need time to get used to dialysis.
Do dialysis patients have to control their diets?Yes. You may be on a special diet. You may not be able to eat everything you like, and you may need to limit how much you drink. Your diet may vary according to the type of dialysis.
Can dialysis Patients travel?Yes. Dialysis centers are located in every part of the United States and in many foreign countries. The treatment is standardized. You must make an appointment for dialysis treatments at another center before you go. The staff at your center may help you make the appointment.
Can dialysis patients continue to work?Many dialysis patients can go back to work after they have gotten used to dialysis. If your job has a lot of physical labor (heavy lifting, digging, etc. ), you may need to get a different job.
Is Kidney Donation Safe?Giving a kidney to someone who needs a transplant is a very generous thing to do. But can it lead to kidney problems in the donor? Most people do not experience health problems as a result of donation. A large study of the long-term effects of kidney donation had good news for people who donate kidneys. Doctors reported that living kidney donors can expect to live full, healthy lives. Donors had very few long-term health problems, in most cases. The study looked at almost 4,000 people who donate one of their two kidneys since 1963. Their long term survival rate was similar to non-donors and they did not have an increased risk of kidney failure. Researchers at the University of Minnesota examined the long-term results for health diagnoses and causes of death. Living donation means that a living person donates a kidney to someone in need of a transplant. The donor is most often a close family member, such as a parent, child, brother or sister. A donor can also be a more distant family member, spouse, friend or co-worker. Non-directed donors, those who donate anonymously and do not know their recipients, are also becoming more common.
Kidney donors’ survival was similar to that of the general population when matched for age, sex, and race or ethnic group. Of 3,700 donors, the need for dialysis or transplant developed in only 11 donors, which is actually a lower rate than in the general population. Donors reported their quality of life was “excellent.”
Kidney donors tend to be healthier than the average person, able to tolerate surgery well and return to a healthy lifestyle. Potential donors are screened for high blood pressure and diabetes, two of the main causes of kidney disease. This group of donors tended to be young and Caucasian, so the University of Minnesota is participating in an ongoing study that will examine a larger and more diverse donor group.
More than 105,000 people are currently on the national waiting list to receive a kidney from a deceased donor. Due in part to new surgical techniques that have shortened recovery times, living kidney donation has become more common in recent years.
Many people who need transplants of organs and tissues cannot receive them because of a shortage of donations. Every month, more than 2,000 new names are added to the national waiting list for organ transplants, and about 18 people die every day while waiting for an organ transplant in the U.S.
Organ and tissue donation helps others by giving them a second chance at life.