100 Questions & Answers About Kidney Dialysis PDF
Preview 100 Questions & Answers About Kidney Dialysis
uestions Q Health/Self-Help uestions S Q ta Lawrence E. Stam, MD m nswers nswers 100 A 100 A & & About Kidney Dialysis 1 0 About What do the 0 EMPOWER YOURSELF ! Whether you are a newly diagnosed patient with chronic kidney disease or have a friend Q kidneys do? or relative undergoing kidney dialysis, this book offers help. Kidney Dialysis 100 Questions & Answers u About Kidney Dialysis gives authoritative and practical answers to your questions about e kidney dialysis including preparation, nutrition, complications, and tips for maintaining s t a healthy lifestyle. Insider tips and advice are given from both physicians and actual i Can kidney patients, making this book an invaluable resource for any individual coping with the o n physical and emotional turmoil of kidney disease or dialysis. s disease be & inherited? A “Dr. Stam’s clear and excellent compilation of information on dialysis, 100 Questions & n Answers About Kidney Dialysis, will be extremely valuable to patients with chronic kidney s disease and their families. It will be of great use to nurses, technicians, dietitians, and w What is dialysis? physicians who care for dialysis patients. With an easy-to-read format, the book delivers a e great deal of information in a clear, concise, and interesting presentation.” r s — John F. Sullivan, MD A Director of Dialysis Operations Since beginning b Th e Rogosin Institute o New York, NY u dialysis, I feel t K “I wish a book like this was available when I started hemodialysis. It answers all the questions tired all the time. i you don’t know you need to ask. It’s simple to understand and a good reference guide.” d n Will this improve — Wendy Rivers e Hemodialysis Patient y with time? D ia l y s Why do I have to i s watch what I eat? What will happen Jones and Bartlett Publishers if I decide to 40 Tall Pine Drive Sudbury, MA 01776 stop my dialysis by 978-443-5000 Jones [email protected] and treatments? Lawrence E. Stam, MD www.jbpub.com Bartlett 54174_CVRF_Stam.indd 1 6/15/09 1:40:04 PM 54174_FMxx_FINAL.QXD 6/15/09 3:41 PM Page i 100 Questions & Answers About Kidney Dialysis Lawrence E. Stam, MD New York Methodist Hospital The Rogosin Institute 54174_FMxx_FINAL.QXD 6/15/09 3:41 PM Page ii World Headquarters Jones and Bartlett Publishers Jones and Bartlett Publishers Jones and Bartlett Publishers 40 Tall Pine Drive Canada International Sudbury, MA 01776 6339 Ormindale Way Barb House, Barb Mews 978-443-5000 Mississauga, Ontario L5V 1J2 London W6 7PA [email protected] Canada United Kingdom www.jbpub.com Jones and Bartlett’s books and products are available through most bookstores and online booksellers. To contact Jones and Bartlett Publishers directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jbpub.com. Substantial discounts on bulk quantities of Jones and Bartlett’s publications are available to corporations, professional associations, and other qualified organizations. For details and specific discount information, contact the special sales department at Jones and Bartlett via the above contact information or send an email to [email protected]. Copyright © 2010 by Jones and Bartlett Publishers, LLC All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner. The authors, editor, and publisher have made every effort to provide accurate information. However, they are not responsible for errors, omissions, or for any outcomes related to the use of the contents of this book and take no responsibility for the use of the products and procedures described. Treatments and side effects described in this book may not be applicable to all people; likewise, some people may require a dose or expe- rience a side effect that is not described herein. Drugs and medical devices are discussed that may have lim- ited availability controlled by the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical practice, and government regulations often change the accepted standard in this field. When consideration is being given to use of any drug in the clinical setting, the healthcare provider or reader is responsible for determining FDA status of the drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations on dose, precautions, and contraindica- tions, and determining the appropriate usage for the product. This is especially important in the case of drugs that are new or seldom used. Production Credits Executive Publisher: Christopher Davis Senior Editorial Assistant: Jessica Acox Production Director: Amy Rose Production Editors: Rachel Rossi/Laura Almozara Manufacturing and Inventory Supervisor: Amy Bacus Composition: Paw Print Media Cover Design: Carolyn Downer Cover Images: Top left photo: © Carme Balcells/ShutterStock, Inc.; Top right photo: © Monkey Business Images/ShutterStock, Inc.; Middle photo: © Daniel Mirer/New York Methodist Hospital; Bottom photo: © iofotopub/ShutterStock, Inc. Printing and Binding: Malloy, Inc. Cover Printing: Malloy, Inc. Library of Congress Cataloging-in-Publication Data Stam, Lawrence E. 100 questions and answers about kidney dialysis / Lawrence E. Stam. p. cm. Includes bibliographical references. ISBN-13: 978-0-7637-5417-4 (alk. paper) ISBN-10: 0-7637-5417-X 1. Hemodialysis—Popular works. I. Title. II. Title: One hundred questions and answers about kidney dialysis. RC901.7.H45S67 2010 617.4'61059—dc22 2008052442 6048 Printed in the United States of America 13 12 11 10 09 10 9 8 7 6 5 4 3 2 1 54174_FMxx_FINAL.QXD 6/15/09 3:41 PM Page iii Dedication To my wife Claudia,the great love of my life now and always. 54174_FMxx_FINAL.QXD 6/15/09 3:41 PM Page iv 54174_FMxx_FINAL.QXD 6/15/09 3:41 PM Page v Contents Preface vii Acknowledgments ix Part 1:The Basics 1 Questions 1–11 cover basic information regarding the kidneys and their functions, including: • What do the kidneys do? • Where are the kidneys located? • Can kidney disease be inherited? Part 2:Dialysis 19 Questions 12–28review general notes on dialysis, such as: • What is dialysis? • Can children be treated with dialysis? • What will happen if I skip a dialysis treatment? Part 3:Preparing to Begin Dialysis 53 Questions 29–43provide an introduction to the dialysis procedure and the medical personnel involved: • What is a nephrologist? • How does my doctor know I need dialysis? • What is a shunt or access for dialysis? Part 4:Living Well on Dialysis 89 Questions 44–56focus on continuing your lifestyle, with topics such as: • Since beginning dialysis, I feel tired all the time. Will this improve with time? • Can dialysis patients be sexually active? • Can I travel as a dialysis patient? 54174_FMxx_FINAL.QXD 6/15/09 3:41 PM Page vi 100 QUESTIONS & ANSWERS ABOUT KIDNEY DIALYSIS Part 5:Nutrition on Dialysis 113 Questions 57–66offer information regarding your diet and nutritional needs while you are on dialysis: • Why do I have to watch what I eat? • What is a renal diet? • Why are potassium and phosphorus so important? Part 6:Complications on Dialysis 137 Questions 67–77present methods of coping with day-to-day problems associated with dialysis, such as: • What should I do if I develop bleeding from my access? • Why does my blood pressure fall too low during my hemodialysis treatment? • Why do I feel weak after my hemodialysis treatments? Part 7:Dialysis:A Healthy Lifestyle 163 Questions 78–89address ways by which you can maintain a healthy lifestyle while receiving treatments: • How can I lose weight as a dialysis patient? • Can dialysis patients participate in sports? • How will being a kidney dialysis patient affect my teeth? Part 8:Getting OffDialysis 195 Questions 90–100provide information on ending dialysis as well as facts on kidney transplants, including: • Can I recover my kidney function? • What will happen if I decide to stop my dialysis treatments? • How can I get a kidney transplant? Appendix 215 Glossary 219 Index 233 vi 54174_FMxx_FINAL.QXD 6/15/09 3:41 PM Page vii Preface All of us know someone with kidney disease. Many of us have a friend or a family member on dialysis.This is because the number of people in the United States and the developing world with kidney disease is growing rapidly. In 2006 in the United States, 500,000 patients received some form of end-stage renal disease therapy.The Medicare cost to treat kidney disease was $23 billion. Patients with kidney disease get a great deal of advice from well- meaning friends and family members. They are encouraged to drink more fluids to flush out the kidneys or to drink cranberry juice.Much of this advice is wrong. The most common reaction to learning that one has kidney disease is fear. Patients are afraid of dying, of suffering pain and disability, and of the unknown impact that kidney disease and dialysis will have on their lives. 100 Questions & Answers About Kidney Dialysis is a user-friendly guide to kidney disease and dialysis. It gives basic information about kidney disease in language that is comprehensible to people without a scientific or healthcare background. It will help patients who are facing dialysis treatments learn what to expect and help prepare them for beginning dialysis treatments.The book’s candid treatment of difficult questions such as “How long can I live on dialysis?” is designed to encourage patients to discuss important and difficult issues with their doctors and families. The more knowledge a patient has about kidney disease, the less fear he or she will have about starting treatment. 54174_FMxx_FINAL.QXD 6/15/09 3:41 PM Page viii 100 QUESTIONS & ANSWERS ABOUT KIDNEY DIALYSIS Dialysis was one of the most significant medical achievements of the twentieth century. Dialysis is life sustaining and improves the quality of patients’ lives. It is important to remember that dialysis treatments have only been available to large numbers of patients for the past 40 years.The forces of globalization and economic devel- opment are bringing dialysis treatments to more patients and to areas of the world where dialysis has not been available before.The continued improvement in dialysis machines, dialysis membranes, new medications, and our understanding of kidney failure will result in significant improvement in dialysis treatments during the twenty-first century. viii 54174_FMxx_FINAL.QXD 6/15/09 3:41 PM Page ix Acknowledgments The process of writing 100 Questions & Answers About Kidney Dialysis involved continuing conversations with several patients receiving dialysis treatments at the Rogosin Brooklyn Dialysis Unit, located at the New York Methodist Hospital in Brooklyn, New York. These conversations were invaluable in looking at kid- ney disease in new ways and developing creative strategies to face dialysis treatments. I would especially like to thank Erick Lucero, Henry Spellman, George Garcia, and Yoshi Reynolds for their hard work on this book. Staff members at the Rogosin Brooklyn Dialysis Unit helped provide expert information in their fields. Robin Grande,LMSW;Lisa Modica,RD,CDN;Ellen DeMarco, RN, MSN, MBA; Vera Auerbach; and Kotresha Neelakantappa, MD, all worked hard to make this book possible.Thank you Rox- anna Bologa, MD, for your guidance on peritoneal dialysis. My wife Claudia S.Plottel,MD,gave me constant support,encourage- ment,and technical assistance.
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