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Download a brochure about diabetes and dialysis (feasible solutions):Diabetes & dialysis:"Diabetes accelerates many degenerative processes at the organic and functional levels. On dialysis, diabetes complications can turn the treatment itself into a chronic drama.The task of replacement therapies is to offer targeted and comprehensive responses, capable of safeguarding the clinically compromised patient"
http://www.diabetes-and-dialysis.com/en/diabetes_solutions/index_solutions.htm

What types of dialysis are there?:Scripps Health:"There are two types of dialysis. Hemodialysis is performed at a special dialysis unit and peritoneal dialysis is performed at home. In San Diego, 90 to 95 percent of dialysis patients choose hemodialysis. Your nephrologist will help you select the treatment that is best for you, and if necessary, refer you to a dialysis center or location thatís convenient for you. Dialysis centers must comply with strict criteria set by the federal government. This national standard for quality care for dialysis patients is always met or exceeded by the dialysis center used by Scripps-affiliated physicians"
http://www.scrippshealth.org/25_628.asp

Preparing for emergancies for dialysis patients (includes forms to print out):Medicare:"This guide has broad tips on how to prepare for an emergency if you have permanent kidney failure ( end stage renal disease) . These tips will NOT work for every patient or in every emergency situation. You may have special health problems or face unique conditions that make a different answer better for you. You should always contact your own doctor for medical advice. Do not rely on this guide as a source of medical advice or treatment. If you require immediate medical attention, try first to contact your own doctor or dial 9-1-1. If you must go to a dialysis center or hospital other than your own, have your medical information available for your caregivers. This section allows you to record some of this information. Other ways you can be prepared are: keep important medical information up to date; document past treatments and operations; keep records of your insurance claims; carry your insurance card; stock a first aid kit; and remember your flu shots and check ups."
http://access.adobe.com/perl/convertPDF.pl?url=http://www.medicare.gov/Publications/Pubs/pdf/esrd.pdf

Living day-to-day with kidney dialysis:Food and drug administration:"Except for the initial needle stick, the procedure doesn't hurt. "You never get used to the needles, you just learn to handle them," he says with a laugh. "Sometimes I feel sick on my stomach if my blood pressure drops, but other than that, it's not bad."Robinson is one of approximately 217,000 Americans who receive ongoing dialysis, at an annual cost of $11.1 billion nationwide. Since the late 1960s, the procedure has been used in place of kidneys lost to disease, birth defects, or injury. It can be used temporarily until the kidneys resume function or the patient receives a transplant, or for years if those options are not available. With dialysis, Robinson and many others like him can live full and active lives. In fact, Robinson works full-time as an investigator with the Food and Drug Administration's Orlando office. His job requires him to walk distances through production plants, climb ladders, and lift boxes to inspect products. He travels to cities all over Florida to conduct inspections. The overnight trips are not a problem as long as he schedules dialysis ahead of time in the cities he visits"
http://www.fda.gov/fdac/features/1998/198_dial.html

Hemodialysis dose and adequacy:NIDDK:"When kidneys fail, dialysis is necessary to remove waste products such as urea from the blood. Urea is not very toxic by itself, but its level represents the levels of many other waste products that build up in the blood when the kidneys fail. To see if dialysis treatments are removing enough urea, the clinic should periodically--normally once a month--test a patient's blood to measure dialysis adequacy. Blood is sampled at the start of dialysis and at the end. The levels of urea in the blood in the two samples are then compared. There are two methods to assess dialysis adequacy in general use, URR and Kt/V"
http://www.niddk.nih.gov/health/kidney/summary/hemodose/index.htm

Peritoneal dialysis dose and adequacy:NIDDK:"Other factors that determine how efficiently a person's blood is filtered can be controlled. Controllable factors include the number of daily exchanges and the dwell time, which is the length of time the dialysis solution stays in the abdomen. When fresh solution is first placed in the abdomen, it draws in wastes rapidly. As the solution becomes more nearly saturated with wastes, it cleans the blood less efficiently. For example, a patient may perform one exchange over the course of 6 hours, until the solution is saturated with wastes. But in the second half of that exchange, wastes are being removed from the blood very slowly. If the patient performed two 3-hour exchanges instead, the amount of waste removed would be substantially greater than that removed in one 6-hour exchange."
http://www.niddk.nih.gov/health/kidney/pubs/kidney-failure/peritoneal-dose/peritoneal-dose.htm

BUN What does the test result mean?:Lab tests online:"High BUN levels suggest impaired kidney function. This may be due to acute or chronic kidney disease. However, there are many things besides kidney disease that can affect BUN levels such as decreased blood flow to the kidneys as in congestive heart failure, shock, stress, recent heart attack or severe burns; conditions that cause obstruction of urine flow; or dehydration. Low BUN levels are not common and are not usually a cause for concern. They can be seen in severe liver disease or malnutrition but are not used to diagnose or monitor these conditions. Low BUN is also seen in normal pregnancy. In most cases, test results are reported as numerical values rather than as "high" or "low", "positive" or "negative", or "normal". In these instances, it is necessary to know the reference range for the particular test. However, reference ranges may vary by the patient's age, sex, as well as the instrumentation or kit used to perform the test. To learn more about reference ranges, please see the article, Reference Ranges and What They Mean. To learn the reference range for your test, consult your doctor or laboratorian."
http://www.labtestsonline.org/understanding/analytes/bun/test.html

Traveling as a dialysis patient:aakp:"Begin no less than three months in advance, contacting hemodialysis units surrounding the location you wish to visit. Your dialysis unit should be able to provide unit names and numbers, if not, try the American Association of Kidney Patients. Contact the dialysis units and ask for their requirements for accepting you as a transient patient. When traveling from city to city, take into consideration train connections and travel times. You can contact the units yourself in a couple of ways. You can fax the units to request information, check availability or reserve a spot. You can also call European units directly. Many countries use English as a second language. You can also contact the units through AT&T's translation service. This service is expensive but it allows you to contact units yourself when English is not spoken"
http://www.aakp.org/Traveling.htm

Financial help for treatment of kidney failure:NIDDK:"In 1972, Congress passed legislation making people of any age with permanent kidney failure eligible for Medicare, a program that helps people over 65 and people with disabilities pay for medical care, usually up to 80 percent. Other public and private resources can help with the remaining 20 percent. Your dialysis or transplant center has a social worker who can help you locate and apply for financial assistance. Medicare is a federally administered health insurance program for people 65 and older and people of any age with permanent kidney failure. To qualify for Medicare on the basis of kidney failure, you must need regular dialysis or have had a kidney transplant, and you must have worked under Social Security, the Railroad Retirement Board, or as a government employee (or be the child or spouse of someone who has), or you must already be receiving Social Security or Railroad Retirement benefits. You can enroll for Medicare at your local Social Security office (check the blue pages in your phone directory to locate the office)."
http://www.niddk.nih.gov/health/kidney/pubs/kidney-failure/financial-help/financial-help.htm

What's the deal with dialysis (a reference for kids and parents):Kids health:"With hemodialysis, your blood travels through tubes to the machine - called a dialyzer (say: die-a-li-zer) - which takes out the extra fluids and waste. Once your blood is clean, the machine sends it back to you through another set of tubes. This process typically takes about 4 hours and has to be done 3 times each week. Two kinds of peritoneal dialysis use a machine. Continuous cyclic dialysis uses a machine to put a cleansing solution called dialysate (say: die-al-ih-sate) in your belly, usually three to five times each night and once during the day. As your blood flows naturally through the vessels in your belly, the dialysate in your belly cleans and rebalances the blood's chemistry. After about 4 hours, the machine drains the dialysate from your belly."
http://kidshealth.org/kid/feel_better/things/dialysis_p3.html

For more information:

American Kidney Fund
American Kidney Fund
6110 Executive Boulevard
Suite 1010
Rockville, MD 20852
(800) 638-8299

National Kidney Foundation
National Kidney Foundation
30 East 33rd Street
New York, NY 10016
(800) 622-9010



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Last updated by Andrew Lopez, RN on Wednesday, September 29, 2010


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