First deep thought: Our Kidneys are meant to last a lifetime! If we take care of them, they will! Good health habits which will help not only our kidneys but all of our bodies are: drinking plenty of fluids; not drinking very much (if any) alcohol; not smoking anything, ever!; eating a balanced diet; getting plenty of exercise and sleep, etc. One item never seen much in the news is overdosing on over-the-counter (non-prescription) medicines. Too much tylenol will kill your liver and the rest of you. Be very, very careful which and how much medicines you take. If your doctor prescribes a new medicine for you, always ask: "What are the common side effects I should look for? Will this hurt my kidneys?"
There are medicines you may be prescribed that will decrease your kidney function over a period of 25 or 30 years such as methotrexate or some psychiatric meds. Always ask about side effects.
It cannot be overstated: you must have a regular physician!! Problems can be detected early and taken care of. Personal example: several years ago, at a routine yearly check-up, my doctor told me, "There's blood in your urine (microscopic). I think you have a bladder infection." I received one course of antibiotics, got rechecked: still blood in the urine. He prescribed another course of antibiotics. Same result: blood in the urine. He had a urine culture done: no bacteria. He told me, "I think you have another problem. Let's get an x-ray." The x-ray revealed extensive kidney stones! One kidney had a bunch of small stones and the other had what is called "staghorn kidney stones," basically a calcification of the lining of the kidney! Then he sent me to a specialist, a urologist. I had four surgeries as a result, including a parathyroidectomy (one of the four glands in the neck removed). The important thing was: I never had one symptom, NO PAIN, NO BLOOD IN MY URINE! If the doctor had not detected problems on a routine check-up and I had waited until I was in pain, I might have lost both my kidneys!!! (And then had to have dialysis.)
Second deep thought: IF you have major physical problems, this might include cancer or heart problems or loss of kidney function, ASK your doctor, "What are my OPTIONS?" There usually are several options for treatment. YOU must choose among them!
Before I retired, an ICU nurse and I had a conversation about dialysis treatment options. He was studying for a Doctor of Nursing degree (DNP) and had a friend who needed dialysis. He asked me, "If you had to choose between dialysis and a kidney transplant, which would you choose?"
I talked with all my colleagues for several weeks about this. We weighed all options. In view of the fact that, if a person receives any organ transplant, anti-rejection medications would need to be taken for the rest of the person's life (at this time), and, we had first-hand knowledge of the dialysis process and all options, we unanimously chose dialysis over kidney transplant. That is what I would do.
There are two kinds of dialysis: HEMOdialysis and PERITONEAL dialysis. In HEMOdialysis, the blood is cleaned of extra fluid and wastes by filtering your blood by a machine. Two lines (plastic tubes) are needed: one to take the blood out and one to put the same blood back in you. Most dialysis patients receive HEMOdialysis. Note: if you have kidney failure in the United States, you will receive Medicare (you have to apply for it).
The great majority of United States patients (93%) with kidney failure receive hemodialysis treatment. Most of these get their treatment in outpatient dialysis clinics. You may have seen some of them around your town: Fresenius, DaVita, etc. Patients go to the clinics three times per week for treatments of four hours each. What you drink is severely restricted. What you eat is also severely restricted because the potassium and phosphates in food will hurt you.
A recent treatment option is HOME hemodialysis. You have your treatments in your own home. The advantage is that you tend to get very few infections at home! This is a huge advantage. You need someone who will help you with this. Training will be given to you and your caregiver. Another huge advantage is that you can do home hemodialysis for a shorter time, daily. This mimics natural kidneys. You usually will be able to have a fairly normal diet. Less than 1% of patients do home hemodialysis in the United States.
A different kind of treatment for kidney failure is called PERITONEAL DIALYSIS. Your blood is cleaned by using a membrane in your abdomen, the peritoneum, for blood exchange. Fluid is pumped into your abdomen through a single plastic tube; the fluid stays in your belly for an hour or two and is drained out through the same tube. When it is drained out, it brings with it some of the extra fluid and wastes in your blood. Peritoneal dialysis is always done at home. The patient is trained. There are also advantages to this option: 1) your urine function is preserved longer, 2) you usually can eat a drink a normal diet, 3) there are fewer infections, 4) you can do it yourself and 5) it is infinitely easier to travel. The peritoneal dialysis machine is the size of a suitcase. The hemodialysis machines are larger.
Only about 7% of U.S. patients do peritoneal dialysis. Countries in the rest of the world do far more of this. Why? In-clinic hemodialysis is extremely (we're talking billions of dollars here!) profitable for companies in the business and is heavily promoted. The majority of U.S. patients don't know they have kidney problems until they fail and have to have emergency hemodialysis to save their lives!
To find out more about dialysis, go to www.kidneyschool.org. I've met the woman who started this website. I've printed out the whole manual for several patients and for my colleagues on our in-patient dialysis unit. It is comprehensive, understandable, and very helpful.
IF I ever have kidney failure, I would know it is coming because I will continue regular physician check-ups. When the time came, I would do peritoneal dialysis at home. In time, I may need hemodialysis. I would definitely do home hemodialysis. That is my choice. Obviously, other people prefer other treatments. I want to preserve my immune function. Every year, the anti-rejection medicines improve. IF they have a kidney transplant option that would not involve depressing your immunity, I would try that. Scientists are working on an artificial kidney. In time, that will be an option. Tell you one thing: I would be the perfect dialysis patient! I know that you can have a good life, a long life with kidney failure if you do your best!!
Lord God, I thank You for life - may I take very good care of myself, I thank You for love - may I give love to all you bring my way! I also thank You for my nursing career - may I still help people this way!
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