A Nephrologist as a Cancer Patient Finds Enlightenment in a Support Group
Lessons learned about health and illness came not from an extremely busy nephrology practice, but, for me, from becoming a sarcoma (cancer) patient. It started in my thigh but metastasized to my lungs. After intensive chemotherapy and two major chest surgeries, I had a new respect for health, and realized that the experience of battling malignancy paralleled that of being a kidney patient. In fact, my dialysis and transplant patients were my source of inspiration, and still are.
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A Peaceful Mission Silenced
Seventeen years ago, I met Joey--a man who changed my life forever. We became not only partners in life, but in advocacy for ourselves and others who, like ourselves, had to live an effective life while dodging disease and its complications and treatment. We also had to learn to remain positive about our life's journey, to love, learn, and do for others what we had to do for ourselves.
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A Ride Across America 2: A Journey to Promote Organ Donation
In April 2006 (National Donate Life Month), we assembled a team of transplant recipients, living donors, and family members of donors and recipients and completed our second "Big Ride." After loading up our gear, we traveled from San Francisco to New York City on (take a guess...) ATVs!
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A Roundup of Anti-Rejection Medications for the Kidney Transplant Patient
Your body's immune system protects you against foreign invaders such as bacteria and viruses. The problem is that the immune system also recognizes the transplanted organ as a foreign invader and will try to reject it. For this reason, you will be prescribed anti-rejection drugs, also called immunosuppressive agents, in an attempt to dampen down your body's natural immune response.
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A Sticky Situation: Patients' Rights and Options Regarding Cannulation in Hemodialysis
Jim walked into the dialysis clinic and, while he put what he brought with him next to his chair, looked around. He saw the charge nurse and four technicians. He had been "stuck," or had the needle inserted into his arm, by everyone in the room and recalled that one of the technicians had done an excellent job the last time. She had hurt him very little and positioned the needles just right. This resulted in an uneventful treatment. He knew the others also, but none of them had been able to "stick" him as well.
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Another Reason for Good Oral Hygiene
You’ve probably heard how brushing and flossing your teeth daily can help prevent cavities and gum disease, but there might be a new reason to find the energy to clean your teeth. It has to do with the relationship of your teeth and gums to the rest of your body.
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Bush Baby Travels the Globe - Learning about Love, Joy, and Support While Living with Kidney Failure
This is a story about a little stuffed koala bear-like animal that has traveled the globe to visit people with end-stage renal disease (ESRD), bringing them love, joy, and support from fellow travelers with kidney failure. The tiny toy creature, called "Bush Baby," has journeyed to five continents, staying with one enthusiastic host or hostess after another.
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Delay the Need For Dialysis With Good Nutrition
People who have been diagnosed with decreased kidney function often find themselves confronted with many lifestyle changes, including their diet. But there are steps that can be taken to help prolong kidney function. Following the right diet is one way that you can help slow down the damage to the kidneys and delay the need for dialysis.
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Diabetes Mellitus - Knowing Your Dialysis Treatment Numbers
[If you have end-stage renal disease (ESRD) and are on dialysis, you will need regular monitoring by your renal healthcare team staff. Your treatment can be effectively assessed by using the "numbers" obtained from the many blood and other tests that are regularly taken.
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Dialysis Treatment During Disasters: Patient Opportunities and Responsibilities in Emergency Planning
Katrina and other devastating events in 2005 exposed problems in providing medical care to kidney patients in disasters as well as in providing food and shelter to the hundreds of thousands who were displaced from their homes. In response to the particular needs of kidney patients, the Kidney Community Emergency Response Coalition (KCERC) has formulated plans to ensure readily available dialysis care during disasters.
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Did You Know? Willem J. Kolff, MD, the Father of Dialysis
Willem J. Kolff, MD, the Father of Dialysis
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Did You Know? Belding Scribner, MD, the Father of Chronic Dialysis, Made History in 1960?
Belding Scribner, MD, the Father of Chronic Dialysis, Made History in 1960
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Did You Know? Nobel Prize Laureate Joseph E. Murray, MD, Performed the First Successful Kidney Transplant
Nobel Prize Laureate Joseph E. Murray, MD, Performed the First Successful Kidney Transplant
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Did You Know? The Term ‘Dialysis’ was First Used in Glasgow, Scotland, in 1861
The Term ‘Dialysis’ was First Used in Glasgow, Scotland, in 1861
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Drinking Alcohol Responsibly on a Renal Diet
Over 50% of American adults drink alcohol. Alcohol may have beneficial effects when consumed in moderation. This article will review what moderate drinking is, what is a serving size, and the health benefits of drinking.
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Ethnic Dining For the Renal Patient
You can try different ethnic foods on your renal diet! This guide will help you in making menu selections when eating away from home. Follow these general suggestions on dining out:
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Exercise Program Tips for Dialysis Patients
Although you see your physician regularly to control your blood sugar and your BP, what are you doing to increase your physical activity? It is equally as important--and maybe even easier to control--than BP and blood sugar. You can be more physically active, and it may just save your life.
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Fast Food Facts
Quick-service restaurants provide us with a quick, easy, inexpensive bite when we’re pressed for time.
If you are a regular through the drive-up window or frequently dine in at fast food restaurants, keep these tips in mind:
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Generic Medications: Are They Right for You?
There are some things that everyone, particularly dialysis and kidney transplant patients, taking generic medications should understand to protect themselves and to feel confident about the medications they are taking.
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Glossary of Terms
A glossary of renal terms and definitions.
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Health Promotion, Disease Prevention, and Chronic Kidney Disease
These are but a few ways you can maintain a healthy lifestyle. As you take a more active role in your own healthcare, the benefits of increased energy, general well-being, and a potentially longer life are all possible.
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Herbal Supplements for the Kidney Patient: Caveat Emptor
When it comes to herbs, they should be thought of as diluted drugs and should not be taken before consulting your physician. If you are someone with kidney disease who may be contemplating purchasing OTC herbal medications, it would serve you well to consider the old phrase, caveat emptor, or "Let the buyer beware."
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How Can You Care For Your New Kidney Transplant?
No matter how long you have your new kidney, your body will always know that it does not belong to you and will try to attack it. As long as you have a working kidney transplant, you will be taking medicine to prevent rejection.
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How Your Kidneys Work and the Five Stages of Chronic Kidney Disease
Kidney disease is the loss of the kidneys' ability to adequately perform critical functions important to maintaining life. Most renal diseases destroy both kidneys simultaneously, and the damage can occur slowly over many years. The process is usually painless.
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Is Anybody Listening? The Kidney Patient’s Role in Doctor/Patient Communication
The question is, “Doctor, can you hear me?” The answer is, “Patient, are you listening?”
This question and this answer are repeated hundreds of times a day as physicians and patients interact. The real question is: “Is anybody listening?” The real answer is: “Very few people are listening.”
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It's About Choice: A Benefits vs. Burdens Analysis
"If I couldn't see my life improving on dialysis, I wouldn't want to live."
Many patients make similar statements to show how they feel or how they think when faced with the burdens of dialysis. If they are suffering losses in physical or mental function, they might see their quality of life falling to a level lower than what they could accept. They might choose to simply stop dialysis.
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Living Long and Well on Dialysis
Your medical team should explain all the different treatment options to you so that you can make an informed decision. Do some research on your own. There is a wealth of information on the Internet. Learn more about the different options and then make a choice that works for you and your family.
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Longer Hemodialysis Is Better than Shorter Hemodialysis
Even one hour longer on dialysis will bring remarkable improvement within only a few weeks! The longer dialysis duration is particularly beneficial in patients who do not make any urine.
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Make the Most of Your Doctor Visit
I have been on this journey now for nearly 10 years. From what I have learned, I recommend that anyone with a life-threatening health condition develop a collaborative partnership with his or her doctor and medical team.
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Managing Stress: What Kidney Patients, Family Members, and Caregivers Need to Know
Trying to replace what kidneys used to do requires hemodialysis treatments three times a week, or daily exchanges for the peritoneal dialysis patient, or a renal transplant. But dialysis is just the beginning. There are daily medicines, dietary restrictions, fluid limitations, and financial burdens that accompany dialysis treatments. This can result in extreme emotional stress.
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Medication Reconciliation: A Practical Guide For Dialysis and Transplant Patients
We’ve all heard the stories about people who were given the wrong medication or the wrong dose of medication in the hospital. These stories often have devastating outcomes, and people become scared of the care that is being provided by healthcare workers.
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My Journey as a Peritoneal Dialysis Patient to a Normal Life
No doubt, like anyone else who deals with chronic illness, I wondered with amusement if I even knew what a “normal” life is anymore. How could I--with PKD and CKD that led to PD (as well as all those other mysterious combinations of medical letters)?
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New Version of MedActionPlan™ Helps Transplant Patients Manage Their Post Operative Care
Are you concerned that there are too many instructions to follow and that your doctor’s directions are confusing and hard to read? If that’s the case, there is help at your fingertips. MedActionPlan version 4.0 is a powerful, Internet-based tool that has helped both transplant centers and patients throughout the country.
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Nutrition Tips For Enhancing the Dialysis Patient's Quality of Life
Good nutrition is a very important part of your renal treatment plan whether you are on hemodialysis (HD) or peritoneal dialysis (PD). To move forward with your best in all aspects of your life as a kidney patient, make an effort to maintain yourself by eating enough of the right kinds of foods or less of those "forbidden" foods.
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Opinion - How is Dialysis Paid For in the US?
The title of this article seems like a simple question, but it's a complicated situation, so there really is not a simple answer. In 2004 (the most recent year for which data are available), nearly 500,000 people had Stage 5 chronic kidney disease (CKD-5, a condition so severe that to live a person needs either a kidney transplant or regular dialysis treatments), and 336,000 individuals were treating their CKD-5 with either hemodialysis (HD) or peritoneal dialysis (PD).
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OPO Official Addresses the Alleged Premature Organ Retrieval Actions of a Transplant Physician
According to a detailed report in the Los Angeles Times, Hootan Roozrokh, MD, a transplant surgeon from San Francisco, CA, was criminally charged with possibly hastening the death of Ruben Navarro, a severely disabled, cognitively impaired 25-year old, 80-pound man with the purpose of facilitating the premature harvesting of his organs. He was accused by the San Luis Obispo County District Attorney of "dependent adult abuse, administering a harmful substance, and prescribing controlled substances without a legitimate medical purpose." The felony charges are believed to be the first in the US against a physician for his role in an organ transplant.
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Overcoming the Stumbling Blocks of Kidney Disease
Did you ever think life just wasn't treating you right? Maybe things were just going along great and the Boom!--something happens to change your entire life's focus. Maybe you thought you had a handle on a particular problem or issue, and then one little change turns your world upside down.
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Overview of Hemodialysis
Hemodialysis (HD) is a treatment option for kidney failure. When confronted with the seriousness of renal or kidney failure, most patients find it difficult to understand all of the various aspects of their treatment. There are many questions that go unasked and unanswered. For example: "How does the artificial kidney or dialyzer work?" Another question commonly asked is: "I see blood going through a series of tubes. What is happening to my blood?" Read on to find the answers to these commonly asked questions.
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Polycystic Kidney Disease (PKD) and the PKD Foundation: What Every Family Needs to Know
More than 600,000 Americans and 12.5 million people worldwide battle polycystic kidney disease (PKD) each and every day. PKD is the most common of all life-threatening genetic diseases, affecting more people than Down’s syndrome, cystic fibrosis, muscular dystrophy, hemophilia, sickle cell anemia, and Huntington's disease combined. Yet, there is no treatment or cure for PKD.
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Preparing for Dialysis: A Guide for People on Dialysis (Medical Emblems)
This useful information prepared by CMS provides information on how to obtain a medical emblem that will aid you in identifying you in the event of an emergency.
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Preparing for Emergencies: A Guide for People on Dialysis (3-Day Emergency Diet Plan)
Emergencies caused by severe weather or disasters can happen with or without warning. This helpful 3-Day Emergency Diet Plan prepared by CMS, provides useful information and tips to aid you in your emergency preparedness so you can feel better and stay healthier.
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Preparing for Emergencies: A Guide for People on Dialysis (Emergency Food List)
Emergencies caused by severe weather or disasters can happen with or without warning. This Emergecny Food List prepared by CMS, is to be used in conjuction with the 3-day Emergency Diet Plan and will aid you in your emergency preparedness so you can feel better and stay healthier.
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Preparing for Emergencies: A Guide for People on Dialysis (Helpful Tips in an Emergency)
Emergencies caused by severe weather or disasters can happen with or without warning. This helpful guide prepared by CMS, divided conveniently into sections on our website for your use, provides useful information and tips to aid you in your emergency preparedness so you can feel better and stay healthier.
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Preparing for Emergencies: A Guide for People on Dialysis (How to Get Off of a Dialysis Machine in an Emergency Evacuation)
Emergencies caused by severe weather or disasters can happen with or without warning. This helpful guide prepared by CMS, provides useful information and tips on How to Get Off of a Dialysis Machine in an Emergency Evacuation.
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Preparing for Emergencies: A Guide for People on Dialysis (Steps to Prepare for an Emergency)
Emergencies caused by severe weather or disasters can happen with or without warning. This helpful guide prepared by CMS, divided conveniently into sections on our website for your use, provides useful information and tips to aid you in your emergency preparedness so you can feel better and stay healthier.
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Preserving Your Lifeline: What You Should Know About Vascular Access Monitoring and Surveillance
As a patient using a graft or fistula for dialysis, one of your highest priorities for maintaining your health and well-being is to make sure that your vascular access is working properly. Problems with your access can decrease the effectiveness of your treatments and lead to hospitalization or loss of your access. What can be done to help keep your access working properly?
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Recommendations For Handling Pets in the ESRD Setting
Pets have been part of man’s household for thousands of years. They provide us with unconditional affection and companionship. Recent studies suggest that, in addition to providing a social support, pets lower one’s stress response, improve the sense of well-being, and reduce depression. As a result of these studies, pets have been introduced into the hospital and nursing home settings with beneficial effects on patients. In many cases, blood pressure or antidepressant medications have been reduced in some patients as a result of pet therapy.
In addition to definite health benefits however, pets pose some health risks, particularly to those with compromised immune function. These risks are especially important for individuals with renal transplants.
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Renal Acronyms
A list of acronyms for renal terms.
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Seeing the Big Picture: Communicating With Your Nephrologist About Goals and Expectations
What are the expectations of my patients, and how do they compare with my own expectations of them? Is there more that we can do together to allow patients to accomplish those goals? Free and open communication is an absolute necessity if patients are to achieve their goals and not fall prey to the trap of low expectations coming either from themselves or their caregivers.
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Sleep Apnea and Kidney Disease
Sleep apnea (SA) is a serious condition that is particularly important for patients with kidney disease to identify and understand. Complications include hypertension, heart attacks, strokes, and even sudden death. Just as importantly, SA affects individuals on a daily basis, causing fatigue, headaches, depression, and overall diminished executive functioning, which can lead to strains on interpersonal relationships and loss of productivity in daily endeavors.
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Slip, Slop, Slap- Preventing Harmful Effects of the Sun
Warnings about the damaging effects of the sun’s ultraviolet (UV) rays on the skin have been at the forefront of health advice for years. As a kidney transplant recipient, I know that the chance of getting skin cancer is much higher for me than for the rest of the population.
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Smart Snacking Choices for the Dialysis Patient
Hungry? Not sure what to eat when you get the munchies? The following are some ideas on what to eat in between meals to help you maintain your nutritional well being without all that extra potassium and phosphorus. Each “smart snack" contains less than 130 milligrams (mg) of potassium and less than 80 mg of phosphorus. Check with your renal dietitian on the number of servings that are appropriate for you.
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Take Charge and Lengthen Your Life
Are you aware that some patients live and enjoy life for 10, 20, even 30 years and longer while on hemodialysis? One of my good friends has been on hemodialysis for 33 years! On the other hand, far too many patients develop problems that curtail long life.
What makes the difference?
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Ten Transplant Tips
Having a transplant can be a wonderful experience, but as in all aspects of treatment you must do your part. What is your part, you ask? Let’s look at the top ten things that you need to know to be successful with a kidney transplant.
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The Advantages of Home Nightly Nocturnal Hemodialysis
The renewed interest in this modality is the result of several recent studies on improving the quality of dialysis. These studies have demonstrated very well that nocturnal dialysis patients are doing much better than they have done on standard in-center dialysis.
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The Courage to Live
My doctors told me that my kidneys would function for about six more years. After that, I would either have to begin dialysis, have a transplant, or die. As a mother, this frightened me. My daughter was just a few weeks old, and my son was only four. I was terrified. I did not want to die and leave my children without a mother.
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The Evaluation and Process of a Kidney Transplant
Anyone who is in or has kidney failure is a potential candidate for a renal transplant. Yet, it's important to know that the procedure comes with both advantages and disadvantages, and it may not be a good choice for everyone.
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The Importance of Oxygen During Hemodialysis
While dialysis patients know that their treatment sessions can be annoying, painful, scary, and draining, they are also aware that they are a lifesaving necessity. Dialysis is work, and work requires energy. Energy requires fuel.
A large amount of energy is necessary for excess water and poisons to move out of our body’s cells and into the tissue fluid, blood, and dialyzer. Each cell in the body has a "powerhouse" called the mitochondria which needs "fuel" to run. Oxygen is the fuel for the "powerhouse" of the cell. (Oxygen isn't everything, but it's right up there with money!)
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The Kidney Connection - Anemia and Kidney Disease
Anemia can be either a temporary or a long-term disease/illness. People with mild anemia may not have any symptoms, or they may have only mild symptoms. Those with severe anemia can feel tired, get short of breath with activity, and have problems doing the things they usually do.
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The Kidney Connection - Diabetes Mellitus
Only 5%-10% of those with diabetes suffer from the more serious type 1 diabetes. In this type, the body stops making insulin, resulting in the need for the patient to take insulin daily.This type is more likely to lead to kidney failure. Up to 40% of those with type 1 develop kidney failure by the age of 50.
The vast majority (90%-95%) of diabetic patientshave type 2 diabetes and do not require daily insulin doses. Type 2 most often occurs in people over 40, but can occur at any age. Many are overweight and do not know they have the disease.
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The Kidney Connection - Glomerulonephritis
Glomerulonephritis (GN), also known as glomerular disease, can be either acute such as a sudden inflammation attack or chronic, which occurs gradually. It can occur as part of a systemic disease like diabetes or lupus or it can be a disease on its own, known as primary GN.
Mini-epidemics of the condition have occurred in certain geographic areas and is most common in individuals aged 40 to 60. The condition sometimes runs in families, indicating a genetic factor.
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The Kidney Connection - Hemolytic Uremic Syndrome (HUS)
Hemolytic uremic syndrome (HUS) is the most common cause of sudden, short-term kidney failure in children, and is most common in kids aged six months to four years. While the condition is more prevalent in children, adults can also get it. Progression to acute kidney failure occurs in about 50% of HUS cases.
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The Kidney Connection - Hypertension
What is hypertension, or high blood pressure (BP)? It's when the force of the blood pumping against the walls of your blood vessels is too high. This causes your heart to struggle to pump blood through the arteries to the rest of your body. Hypertension also damages the blood vessels by making them more narrow and their walls thickerand "harder" (a.k.a atherosclerosis, or hardening of the arteries).
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The Kidney Connection - IgA Nephropathy
IgA nephropathy, also called Berger's disease, was named for the doctor who originally discovered the condition in 1927. It is caused by abnormal deposits of a kind of protein that helps fight infection known as immunoglobulin A (IgA) inside the glomeruli (small blood vessels of the kidneys), resulting in inflammation of the glomeruli.
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The Kidney Connection - Lupus Nephritis
Lupus is short for "lupus erythematosus." The word "lupus" is the Latin word for "wolf." It was named because of the skin rash resembling a wolf's bite that some patients get over the bridge of their nose.
Lupus is an autoimmune disease because the immune system, which usually protects the body from illness, turns against it. This causes harm to organs and tissues, including the skin, joints, kidneys, and brain.
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The Kidney Connection - Renal Bone Disease
Many patients with chronic kidney disease (CKD) are unaware that the kidney is involved with the health of their bones. Renal bone disease (a.k.a renal osteodystrophy) occurs when your kidneys fail to maintain the proper levels of calcium and phosphorus in your blood.
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The Kidney Connection - Restless Legs Syndrome
Restless legs syndrome (RLS) is a movement disorder that causes uncomfortable, unpleasant sensations in the legs. It affects up to 10% of the US population and as many as 40% of those on dialysis. The condition mostly affects older individuals.
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The Kidney Connection - Secondary Hyperparathyroidism
The most common cause of SHPT is CKD. SHPT occurs when damaged kidneys do not convert enough vitamin D to its active form or they may not excrete enough phosphorus.
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The Kidney Connection - Sex and Sexuality
What is sexuality? Many believe it refers only to sexual intercourse, but it actually has a much broader definition. It also refers to self-image, how you communicate with other people, and simply building a relationship. It includes such activities as touching, kissing, and hugging, or just being with each other and participating in activities you both enjoy.
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The Kidney Connection - Skin and Hair Problems
Skin and hair problems affect many people on dialysis. As a dialysis patient, your skin may appear to be more fragile and may tear or bruise more easily than normal.
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The Protein Challenge: Myth or Fact?
Proteins supply amino acids. Amino acids are "building blocks" that build, repair, and maintain your body tissues. Your body uses protein to:
Make enzymes, hormones, and other body chemicals;
Carry nutrients;
Make muscles contract; and
Regulate body processes.
Read on to see how "protein savvy" you are...
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The Use of Peritoneal Dialysis in the Management of Kidney Failure
Peritoneal dialysis (PD) is one of the generally available and internationally used forms of treatment and management of patients who reach end-stage kidney failure. It is the primary form of treatment for renal failure used at home and for self-dialysis.
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Tips on Adhering to a Medication Regimen For the Dialysis and Kidney Transplant Patient
As a dialysis or kidney transplant patient, you know that taking medication the way it is prescribed is one of the most important things you can do to help keep yourself as healthy as possible. Even though you know how important it is, medication is not always the easiest thing to swallow.
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Tips on How a Dialysis Facility and Patients Can Prepare for an Emergency
“An emergency stops being one when you are ready for it.”
These words are important to reflect upon when you realize that, during the last few years, the United States has experienced several disasters (particularly Hurricane Katrina) that seriously disrupted the lives of many dialysis patients because they could not get to their clinics to receive treatments. Emergencies caused by severe weather (hurricanes, earthquakes, snowstorms, power outages, etc.) can occur suddenly and without warning. Your availability to water, power, transportation, or supplies may be limited. You may not be able to get to your dialysis unit for treatment or give yourself treatments at home. Therefore, the importance of being prepared for such events cannot be overstated.
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Understanding the Process and Participating in Your Own Healthcare is Key to a Successful Kidney Transplant
An effective organ placement system requires a great deal of communication, planning, cooperation, and trust among the candidate, the transplant coordinators, social workers, nephrologists, and surgeons. Candidates for a kidney transplant are best served if they participate in advanced planning, understand the process, and are forthcoming with their transplant teams.
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Understanding Your Monthly Dialysis Laboratory Values
Laboratory values are only one of many ways that your healthcare is monitored. These values, like many aspects of kidney care, have clinical guidelines and standards for care that have been analyzed and recommended by experts
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What Can Patients Do to Delay the Progression to Complete Kidney Failure?
Your doctor has just informed you that you have chronic kidney disease (CKD). Rather than being a specific diagnosis, CKD means that your kidney function is not completely normal for someone of your age, gender, and race. In CKD, some of the filtering units of the kidneys are not functional. Because of that, the remaining filtering units are working "overtime" in a compensatory attempt to maximize kidney function. While this is helpful in the short run, continued overworking of the filtering units over time may lead to scarring and progressive failure.
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What is Being Done to Increase the Supply of Donor Organs?
Mr. Undis has focused on a significant problem in the United States. The number of candidates on the deceased donor organ waiting list is increasing at a faster rate than the number of deceased organ donors. His solution is to change the organ allocation system so that those candidates who have indicated that they are organ donors for at least six months prior to their need for an organ go to the top of the waiting list, an "A" list so to speak. All others are in a second category, a "B" list. They would only receive an organ if there are any still remaining after the needs of the "A" list are addressed.
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What Patients Need to Understand About Quality Assurance in the Dialysis Center
Quality assurance and continuous quality improvement (QA/CQI) are critical components in the hemodialysis (HD) center. Correctly implemented and managed, QA/CQI not only improves outcomes that have been established by the Centers for Medicare and Medicaid Services (CMS), the End-Stage Renal Disease (ESRD) Networks, and the individual dialysis companies, it also improves the quality of life for the HD patient.
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Why Do Patients Have Bouts of Low Blood Pressure During Hemodialysis?
While most people who eventually require chronic maintenance hemodialysis (HD) had hypertension, or high blood pressure (BP), before they began HD treatments, hypotension (low BP) during the HD treatment sessions is a common problem. It is estimated that 15%-50% of patients receiving HD will have low BP during their treatments.
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