Who should consider Daily Home Hemodialysis?

The main selection criteria for training for daily home hemodialysis are the ability and
willingness to learn, to have a support person at home and to have adequate space for
the equipment and related supplies.
In general:

Patients who are willing to take the time and effort to learn the procedures
Patients who want more independence and control of their treatment
Patients who want more flexibility in scheduling of dialysis treatments
Patients who are required to travel long distances to a dialysis unit

Frequently Asked Questions (FAQs) Part I

I have been meaning to share some FAQs on kidney failure these past few days.
Though I wasnt able to get the chance because of my dialysis schedule. But finally, I
am posting this now to promote awareness on kidney failure.
My heartfelt thanks to the Philippine Society of Nephrology, where I got this
information, and to Dr. Bien Manlutac, the author of this FAQs and had been our
nephrologist at Philippine Kidney Dialysis Foundation
What are the kidneys?
Kidneys are paired bean-shaped, fist-sized blood-cleansing organs of the body. They
are attached to the urinary bladder by tubes called ureters whichconvey urine formed
in the kidney. Each kidney contains hundreds of thousands of tiny filters called
glomeruli, which are interconnected by tubules, to form a network of nephrons, the
working units of the kidneys. Around 200 quarts of blood is pumped by the heart to
the kidneys via the renal arteries. Unclean blood passes through 140 miles of tubes
and filters in both kidneys, resulting in urine formation. Filtered or cleaned blood then
goes back into the circulation via the renal veins. Urine stored in the bladder is then
passed out through the urethra located in the genital organs.
What do kidneys do?

Healthy kidneys function like 24-hour cleansing

machines of the blood, removing from it wastes such as urea and creatinine, and extra
water from the body. They also produce several hormones such as renin that help
control and maintain normal blood pressure, and erythropoietin which stimulate bones
to make red blood cells that carry oxygen to your whole body. They also keep body

chemicals like salt, potassium, calcium, phosphorus, acids and bases in balance and
keep bones strong.
What is kidney failure?
Kidney failure is a condition where the kidneys stop working normally. There are two
kinds of kidney failure: acute renal failure (ARF) and chronic kidney disease (CKD).
In both conditions, the kidneys fail to efficiently remove wastes and extra fluid from
the body. Imbalances in the amounts of salt, potassium, calcium, phosphorus, and
acids may also occur in both.
What is acute renal failure?
Acute renal failure means the kidneys have failed suddenly, often due to a toxin, a
harmful drug, severe blood loss, trauma, infection, or blockage to urine flow. It is
temporary in most cases and normal or near-normal kidney function often returns.
However, it may progress to CKD if left untreated. In severe cases, dialysis may be
necessary for a short time while the kidneys heal.
What is chronic kidney disease (CKD)?
Chronic kidney disease is characterized by either permanent kidney damage that
developed progressively and slowly over time, or decreased level of kidney function
with or without kidney damage for three months or more, with the potential to either
cause progressive loss of kidney function or complications resulting from decreased
kidney function.
What are the stages of CKD?
CKD is classified into 5 stages based on the level of glomerular filtration rate (GFR).
Stage 1 is the mildest stage while stage 5, or end-stage renal disease (ESRD) is the
most severe stage of kidney damage.
What is Pre-ESRD?
Pre-ESRD corresponds to CKD stages I to IV. It is the time between diagnosis of a
kidney disease until the time renal replacement therapy is begun, either as dialysis or
kidney transplantation. It may be brief lasting only a few weeks, or it may be months
or even years.
What are the risk factors for CKD?
Older age, family history of CKD, history of acute renal failure, reduction in kidney
mass and low birth weight place an individual susceptibleto developing CKD.
Diabetes, high blood pressure, autoimmune diseases, systemic infections, urinary tract
infections, urinary stones, lower urinary tract obstruction, drug toxicity, and cancer
can directly initiate kidney damage. Higher level of spillage of protein in the urine
(albuminuria), higher blood pressure, poorly controlled diabetes and smoking can
cause acceleration of kidney damage and faster decline in kidney function.

What are the main causes of kidney disease?

Diabetes is the number one cause of kidney disease, responsible for about 40% of all
kidney failure. High blood pressure is the second cause, responsible for about 25%.
Glomerulonephritis, a group of diseases that cause inflammation and damage to the
kidneys filtering units, is the third leading cause.
Other less common causes include:
* Inherited diseases, such as polycystic kidney disease
* Malformations during fetal development
* Lupus and other diseases that affect the bodys immune system.
* Obstructions caused by kidney stones, tumors or an enlarged prostate gland in men.
* Repeated urinary infections.
I have diabetes. Will my kidneys fail?
Diabetes is a strong risk factor for kidney disease, but this does not necessarily mean
your kidneys will fail. Tight control of your blood sugar and certain medications can
delay or prevent progression of kidney failure. Spillage of protein or albumin in the
urine is the first sign of diabetic kidney disease. Even if you develop diabetic kidney
disease, you can work with your doctor to keep your kidneys working as long as
possible.
Can I catch kidney disease from someone who has it?
No. Kidney disease is not contagious, but it may be inherited. Most kidney diseases
are caused by diabetes and high blood pressure, conditions that can run in families. If
you are a family member of someone who has diabetes, high blood pressure, or
kidney disease, it is a good idea to ask your doctor to check your blood pressure and
kidney function at regular intervals.
I have a family member with polycystic kidney disease (PKD). Should I be
tested?
Since 60-70% of people with PKD have a family member with PKD, asking your
doctor about being tested seems like a good idea. The first test used for PKD is an
ultrasound to look at the kidneys and see if there are cysts.
Does frequent holding of urination cause CKD?

No, unless one suffers from vesico-ureteral reflux disease (VURD) which may
damage the kidneys in the long term.
Will eating too much salty foods lead to CKD?
Eating too much salty foods does not necessarily lead to CKD. However, it can
eventually lead to
high blood pressure among those who are at risk, such as those with a family history
of hypertension. It can also worsen pre-existing hypertension, a leading cause of
CKD. Among those with moderate kidney failure or end-stage renal disease, it can
lead to water retention resulting to edema or swelling of the feet, and water in the
lungs.
Does drinking too much cola or soft drinks lead to CKD?
No, but it may increase blood levels of phosphorus and potassium among those with
moderate CKD.
Read more: http://dialysispostings.com/frequently-asked-questions-faqs-parti/#ixzz0lWnjkoXl