Living With Kidney Disease

168 Pages·2006·3.31 MB·English

Living With
Kidney Disease
th
4 Edition
This information package
is provided free of charge by
The Kidney Foundation of Canada
LIVING WITH
KIDNEY DISEASE
FOURTH EDITION
Copyright © 2006
The Kidney Foundation of Canada
Library and Archives Canada Cataloguing in Publication
Living with kidney disease. -- 4th ed.
Includes index.
1. Kidneys--Diseases--Popular works.
2. Kidneys--Diseases--Treatment--Popular works.
I. Kidney Foundation of Canada
RC902.L59 2006 616.6’1 C2006-900095-6
Ref. No.: ED-90-001-06
This manual is dedicated to all Canadians
with kidney disease, and to their families.
ACKNOWLEDGMENTS
he Foundation would like to thank all those people across Canada who
generously gave their time and effort to make this manual possible. Without
T their encouragement, ideas and support, it would not have been possible.
The Kidney Foundation would like to specifically acknowledge the healthcare
professionals and others from across the country who assisted with this project.
PROJECT MANAGEMENT TEAM
Physician of Record – Dr. Ted Toffelmire, nephrologist, Ontario
Project Sponsor – Beryl Ferguson, The Kidney Foundation of Canada, British
Columbia
Project Manager – Jayne McBryde, Communications Consultant, Quebec
Project Coordinator – Kathy Giangaspero, The Kidney Foundation of Canada,
Quebec
REVIEWERS
Healthcare Professionals
Janet Bick, Government Relations, The Kidney Foundation of Canada, Ontario
Darlene Broad, renal dietitian, Ontario
Shelley Burnett, nurse, British Columbia
Dr. Michael Copland, nephrologist, British Columbia
Michelle Ival, renal dietitian, Ontario
Marilyn Lawlor, renal dietitian, Ontario
Janet Love, nurse, British Columbia
Doug Parsons, social worker, Ontario
Dr. Nilufar Partovi, pharmacist, British Columbia
Shirley Pulkkinen, social worker, Ontario
Dr. Rob Richardson, nephrologist, Ontario
Pamela Dill Smith, renal dietitian, Nova Scotia
Dr. Paul Taylor, nephrologist, British Columbia
Susan Young, nurse, British Columbia
Dr. Jeffrey Zaltzman, nephrologist, Ontario
People Living with Kidney Disease
Marcia Bell, British Columbia
Louis Martin, Ontario
Cyril Muise, Alberta
The publishing of this manual is made possible through charitable gifts from
individuals, corporations and foundations.
INTRODUCTION
This manual was written to help you What does this manual cover?
and your family learn more about living In this manual we look at how the
with kidney disease. The more you kidneys work, the causes and symptoms
know about kidney disease, the easier of kidney disease, and the ways different
it will be to make informed choices kidney diseases are treated. We also
about your treatment. look at how kidney disease may affect
your diet, your emotional and physical
This is the fourth edition of the Living well-being, your family, and the things
with Kidney Disease patient manual. you do for fun and exercise. We also
This edition was produced under the explore issues related to your work life,
jurisdiction of the National Patient as well as provide you with financial
Services Committee and the National and legal information related to living
Communications Department of with kidney disease. We describe the
The Kidney Foundation of Canada. important roles of your healthcare team
This manual is provided free of charge and how they can help you. Finally,
to any Canadian living with kidney we outline the services available to you
disease. Others may obtain a copy through The Kidney Foundation of
of the manual, for a small fee, by Canada, and provide some sample log
contacting their local Kidney Foundation sheets to help you record and manage
office. See Chapter 8 - Support available your own care.
for contact information.
When you’ve finished reading the
An electronic version is available at manual, we hope you’ll share it with
no charge on the Kidney Foundation’s your family and friends. It may help
Web site at www.kidney.ca. them to better understand what you’re
going through.
■
Hints on how to use this manual When we discuss medications, we use
As you read, keep a paper and pencil the generic name of the medication
handy to jot down any questions you rather than the brand name, because
may have for your healthcare team. there are often several brands
You should also feel free to write notes available. The glossary contains a
in the manual because it is meant to be special section which gives examples
a helpful reference tool for you. There is of common brand names for various
space at the end of each chapter where medications.
■
you can write notes. This edition of the manual contains a
■
Whenever we introduce a new or new chapter called “Self-management
important word or term, it is shown tools”. Here we provide several log
in bold italic type the first time it sheets where you can record
appears in the manual. You will find important information about various
the definitions of these words and aspects of your health and treatment.
terms in the alphabetical glossary Feel free to photocopy these sheets
in Section 10. as needed.
■
Sometimes we use italics to ■ For certain words in the manual we
emphasize certain words or phrases. use the American spelling rather than
These words and phrases do not the Canadian spelling because it will
appear in the glossary. be more familiar to most readers.
■
We’ve also created a subject index of
important topics. By looking up a Give us your feedback
topic, you can find all the main pages We hope you find this manual useful.
in the manual where this topic is We’d like to hear your comments and
discussed. suggestions. At the very back of the
■
The pages are numbered beginning manual you’ll find an evaluation
at page 1 for each chapter. Each page questionnaire. Please take a few
number shows both the chapter moments to complete it and return it
_
number and the page number. to us your feedback is important
The chapter number is shown first. and will help us produce future editions
For example, page 3-5 is the fifth of the manual.
page in Chapter 3.
TABLE OF CONTENTS
Chapter 1 – How kidneys work
How do kidneys work? ............................................................................................. 1-1
Why are kidneys so important? ............................................................................... 1-4
How are substances in the blood measured? .......................................................... 1-5
Chapter 2 – Kidney disease
What is chronic kidney disease (CKD)? .................................................................. 2-1
What causes chronic kidney disease? ....................................................................... 2-2
Who is at risk for developing CKD? ........................................................................ 2-4
Kidney diseases .......................................................................................................... 2-4
Diabetes mellitus .............................................................................................. 2-4
High blood pressure ......................................................................................... 2-6
Glomerulonephritis .......................................................................................... 2-7
Autosomal dominant polycystic kidney disease ............................................. 2-8
Urinary tract obstruction ................................................................................. 2-9
Reflux nephropathy .......................................................................................... 2-9
Drug- and medication-induced kidney problems .......................................... 2-10
Other kidney problems .................................................................................... 2-10
What are the signs of kidney disease? ..................................................................... 2-10
Uremia .............................................................................................................. 2-12
What can I do to help prevent the progress of CKD? ............................................ 2-13
What are the treatments for kidney disease? .......................................................... 2-14
What is conservative care? ........................................................................................ 2-14
Chapter 3 – Dialysis
What is hemodialysis? ............................................................................................... 3-2
How do hemodialysis machines work? ............................................................ 3-3
How long does hemodialysis take? ................................................................... 3-4
How are you attached to the dialysis machine? .............................................. 3-5
Does hemodialysis hurt? ................................................................................... 3-9
Where can hemodialysis be done? ................................................................... 3-10
Hemodialysis and lifestyle ................................................................................ 3-13
What is peritoneal dialysis? ....................................................................................... 3-13
How does peritoneal dialysis work? ................................................................. 3-14
How is access to the peritoneal cavity established? ......................................... 3-14
What are the types of peritoneal dialysis? ....................................................... 3-15
What are the problems of ESRD? ............................................................................. 3-18
High blood pressure .......................................................................................... 3-18
Fluid overload ................................................................................................... 3-19
Anemia ............................................................................................................... 3-19
High potassium ................................................................................................. 3-20
Bone disease ...................................................................................................... 3-20
Nerve changes .................................................................................................... 3-21
Skin changes ...................................................................................................... 3-21
Chapter 4 – Transplantation
What is a transplant from a live donor? ................................................................... 4-2
What is a transplant from a deceased donor? .......................................................... 4-4
What is involved in transplant surgery? ................................................................... 4-5
Tests to determine compatibility ...................................................................... 4-5
The transplant operation .................................................................................. 4-6
Kidney-pancreas transplant ............................................................................. 4-7
What tests are needed after the transplant operation? ........................................... 4-8
Blood tests ......................................................................................................... 4-8
Ultrasound ........................................................................................................ 4-8
Renal scan ......................................................................................................... 4-9
Biopsy ................................................................................................................ 4-9
Fine needle aspiration ...................................................................................... 4-9
What is rejection? ...................................................................................................... 4-9
What anti-rejection medications are used? ............................................................. 4-11
Cyclosporine ...................................................................................................... 4-11
Tacrolimus (also called FK506) ........................................................................ 4-12
Azathioprine ..................................................................................................... 4-13
Prednisone ......................................................................................................... 4-14
Mycophenolate mofetil (also called MMF) ..................................................... 4-15
Sirolimus ........................................................................................................... 4-16
Muromonab CD-3 and antithymocyte globulin (ATG) ................................ 4-16
Interleukin 2 (IL-2) receptor blockers (basiliximab, dacluzimab) ................ 4-17
Important guidelines about medications and your transplant .............................. 4-17
What is involved in living with a new kidney? ........................................................ 4-18
Rest and exercise ............................................................................................... 4-18
Nutrition and food choices .............................................................................. 4-19
Recommendations for good health ................................................................. 4-21
Chapter 5 – Eating for health
How does my body use food? ................................................................................... 5-2
How does my body get rid of food wastes? ............................................................. 5-2
Protein ........................................................................................................................ 5-3
Energy foods .............................................................................................................. 5-5
Sodium ....................................................................................................................... 5-5
Potassium ................................................................................................................... 5-6
Phosphorus (phosphate) ........................................................................................... 5-7
Fluids .......................................................................................................................... 5-8
Vitamin and mineral supplements .......................................................................... 5-9
Herbal remedies and “health foods” ........................................................................ 5-10
Dos and don’ts of eating for health .......................................................................... 5-10
Information for people with diabetes ...................................................................... 5-12