#end-stage renal disease

[artisticdivasworld]

Compassionate Care for Chronic Kidney Disease: A Nursing Perspective

Chronic Kidney Disease (CKD) is a progressive loss of kidney function over time. Managing CKD is not just about slowing the progression of the disease but also about enhancing the quality of life for those affected. Nurses play a crucial role in this process, providing care that is as compassionate as it is competent. This blog post will explore the nursing interventions and desired outcomes that…

[macgyvermedical]

Dialysis

You guys ever think about dialysis?

You guys ever think about Willem Kolff, who smuggled 800 Jewish people during WW2. Who in his spare time, while being watched by the Nazis, built a machine out of a bathtub and some sausage casing and spare parts from a car, a sewing machine, and an airplane. A machine that took the place of the human kidney. And it worked.

You guys ever think about how 20 years later on another continent that machine would change forever what we call medical ethics. How a group of 7- a doctor, a lawyer, a minister, a housewife, a union representative, a banker and a government official- had to make the awful decision of which 10 people got to use (at high cost!) the extremely limited number of machines- and who would die waiting.

You guys ever think about Shep Glazer, a traveling salesman with a wife and 2 children, who in 1971 nearly died on the US congress floor undergoing dialysis. Who explained that the treatments were bankrupting him. That money- and money alone- stood in the way of his life. How his pleading to be allowed to see his children grow up led to the universal coverage of ESRD in the United States- something it shares with no other condition.

You guys ever think of those things? Cause I do.

[alifeoutloud]

I started dialysis a few months ago, after ending up in hospital with a creatinine of 15.4.

And I’m sitting here, looking at this machine that leashes me each evening, and it’s a little miracle of science that I’m alive, that I can continue to be alive, in the comforts of my own home, with a dedicated team of professionals available 24/7 to support me: I have doctors, nurses, a dietitian, a social worker, a finance/insurance coordinator…and then the transplant team is even bigger. It’s wild. Truck drivers who come into the house and stack boxes for me, even.

And in the U.S. it’s covered immediately with Medicare, by federal law. Because I’d die without it.

So it can be done. This could be how we handle diabetes. Cancers. This could extend to others, who will die without intervention.

So I am so very lucky(?) to have a terminal chronic disease that is handled like this. Don’t get me wrong, having any chronic illness is exhausting, and there are nights when I feel burdened at the thought of hooking up, but then I remind myself how damn lucky I am (for both the technology and the supports) and then I am enraged that it isn’t common sense for a government to not let its population just die from treatable things…

[crockettmarcel]

loving the unity in the med fandom rn of “die about it archer”

[superflaminggayelmo]

Frustrated by lack of relatable ESRD posts

I really really wish there were more posts about End Stage Renal Disease and everything related to it from other people who also live with it. Stuff about our experiences with kidney failure and dialysis and doctors and the diets they put us on and co-morbid illnesses and just everyday mundane stuff and what it's like to live with this condition. Cause most of the time when I'm looking up ESRD, I just find stuff about pets who have it, or posts from doctors or medical institutes or some study about some supposedly innovative thing in the nephrology world. I crave more relatable content from other humans who have ESRD, because it feels like there's hardly enough out there and I'm tired of it

[minimallyinvasive]

Exploring Minimally Invasive Treatments for May-Thurner Syndrome

The exploration of minimally invasive treatments for May-Thurner Syndrome represents a significant advancement in vascular medicine. Procedures such as endovascular stenting, balloon angioplasty, and catheter-directed thrombolysis offer effective alternatives to traditional surgery, providing patients with safer options and quicker recovery. For more details, visit our website.

[drforambhuta]

Understanding Dialysis:

Dialysis stands as a remarkable medical intervention, effectively mimicking the essential functions of the kidneys by removing waste products, excess fluid, and toxins from the bloodstream. This process is vital for maintaining the body's overall health and preventing the accumulation of harmful substances that can lead to severe complications. Broadly categorized into hemodialysis and peritoneal dialysis, each approach offers distinct advantages and considerations, catering to the diverse needs and preferences of patients.

Hemodialysis:

Hemodialysis represents a widely utilized form of renal replacement therapy, involving the extracorporeal circulation of blood through a specialized machine known as a hemodialyzer. This sophisticated apparatus functions as an artificial kidney, facilitating the removal of waste products and excess fluid from the blood while restoring electrolyte balance. Hemodialysis sessions typically occur several times a week at designated dialysis centers, necessitating the establishment of reliable vascular access through arteriovenous fistulas, grafts, or central venous catheters.

The procedural intricacies of hemodialysis encompass a comprehensive array of considerations, including blood flow rates, dialysate composition, and ultrafiltration targets. Despite its efficacy in achieving adequate clearance of metabolic waste, hemodialysis may pose certain challenges such as the risk of hypotension, muscle cramps, and vascular access-related complications. Furthermore, adherence to a strict dietary regimen and fluid restriction is essential to optimize treatment outcomes and minimize potential adverse effects.

Peritoneal Dialysis:

In contrast to hemodialysis, peritoneal dialysis harnesses the permeable nature of the peritoneal membrane lining the abdominal cavity to facilitate the exchange of solutes and fluids. This modality entails the instillation of a sterile dialysis solution into the peritoneal cavity via a surgically implanted catheter, allowing for the passive diffusion of waste products and excess fluid across the peritoneal membrane. Subsequently, the spent dialysate is drained from the abdomen, completing a cycle of peritoneal dialysis.

The versatility and convenience of peritoneal dialysis render it an attractive option for many patients, offering greater autonomy and flexibility in managing their treatment regimen. Home-based peritoneal dialysis affords individuals the opportunity to undergo therapy while maintaining their daily routines and minimizing disruptions to their lifestyle. Nevertheless, meticulous attention to infection control practices, including proper catheter care and aseptic technique during exchanges, is imperative to mitigate the risk of peritonitis and other infectious complications.

Doctors suggest undergoing a full body health checkup at regular intervals in case of dialysis patients to check the side effects associated with dialysis, its impact on the general health of the patient, and early management of the complications associated with the procedure.

[sangrialagoon]

[txhospitals123]

Best Peritoneal Dialysis Catheter Placement in Hyderabad | Procedure & Treatment

Looking for safe and effective peritoneal dialysis catheter placement in Hyderabad? Our expert surgeons provide the best peritoneal dialysis procedure for end-stage renal disease treatment. Contact us for dialysis catheter insertion today.

[alfakidneycare]

End stage of Renal disease happens to be the last stage of acute or chronic renal failure. read about Causes, Symptoms, Treatment of End stage Renal disease

[prince-liest]

Gonna be a bummer for a bit! (CW fish illness)

Lucy started pineconing slightly a few hours ago and I feel really shitty about it because I don't know what I could have done for this to not have happened, but I'm sure there was something.

Her fin rot visibly and dramatically worsened over the weekend despite a second dose of the antibiotic treatment I was using, and I even had a second medication arrive today, but she was already lethargic and not really eating. She's just been floating in the front corner of the tank where I usually feed her with her belly somewhat swollen, not really moving except to take breaths every once in a while. And then as of the past couple of hours, her scales are popping up a bit, which, in combination with the belly swelling, pretty much guarantees end-stage renal failure resulting in fluid retention, which is a death sentence for a fish.

She's always been such a lively fish full of way more personality than you'd expect from, y'know, a little aquatic creature, and I have been so convinced that she'd live a good life of at least 4-5 years of chasing shrimp around, but here I am with her probably-dead barely a year and a half into her life. It just feels shitty, because this isn't, like, a random death - there's clearly a disease process happening - but I don't know how to fix it or what I should have done to prevent it, except maybe realize that it was happening earlier. I still don't know if the red splotches she developed months and months ago were signs of a latent bacterial infection or just her changing colors like bettas sometimes do.

I've done water changes. Her water parameters are pristine. There's a thriving and reproducing population of adult and baby shrimp in her tank, which are all notoriously bad at handling crappy water. There's no other fish in there to stress her. There are so many plants. I only feed the highest quality betta food I could find based on extensive reviews. I added shrimp for enrichment and snacks. The water is heated. Even a few hours ago, I was convinced that I could get her through this. What happened?

I guess now I just mostly feel bad because barring a miracle, I'm probably going to find her dead tomorrow and it's going to be fucking horrible. Her poor fins look so awful right now. At least she's in a comfortable and familiar place. She's moving around a little more, now, and the pineconing is less obvious in the new light...I'm going to at least hope that I'm wrong about this.

Swim in peace, Lucy, if you don't make it the night.

[macgyvermedical]

Let's Talk ESRD and Dialysis

Have you thanked your kidneys today? Do you feel grateful when you pee? How about when you eat a little too much potassium or drink a little too much water, do you really enjoy feeling confident that your kidneys will just dispose of the excess?

If so, you probably know the alternative.

About 10% of the world's population has a condition called Chronic Kidney Disease, or CKD. About 2 million of those people are in End Stage Renal Disease (ESRD) and require dialysis or a kidney transplant to live.

Your kidneys are amazing things. They are two organs that sit outside of the sac that hold the rest of the abdominal organs, called the peritoneum. They take in blood from the body, determine the levels of electrolytes, water, and waste products in that blood, and remove the waste products and excess electrolytes and water.

They also have secondary tasks. They monitor the amount of red blood cells in your blood and send out hormones that entice the bone marrow to make more when we're low. They also monitor blood pressure and release hormones that raise that blood pressure when it gets low.

Lots of things can hurt the kidneys. For example, poorly controlled high blood pressure and poorly controlled diabetes are among the top reasons why kidneys fail. Additionally, being dehydrated while engaging in strenuous exercise or taking medications like ibuprofen or naproxen (any NSAIDs) can cause kidney damage.

We measure how well the kidneys are working via the Glomerular Filtration Rate, or GFR. This is a measure of (essentially) how much blood in milliliters the kidneys filter per minute. 90 or higher is normal, while a GFR of 15 or lower is considered ESRD.

So let's say someone has a GFR of less than 15 and the decision is made to start them on dialysis and put them on the kidney transplant list. What options do they have?

Well, they need to figure out if they want to do hemodialysis or peritoneal dialysis.

In hemodialysis, the patient is hooked up to a machine that runs their blood across a special membrane. On the other side of the membrane, a solution called dialysate draws excess water, electrolytes, and waste products from the blood. Hemodialysis is usually done at a dialysis center for 3-5 hours, 3 times per week.

Hemodialysis is better for patients who have either failed home peritoneal dialysis or can't or aren't comfortable with doing the technical part of the job by themself at home. There is also a social component, where dialysis is a chance to meet and interact with other people who are going through the same things they are.

People who undergo hemodialysis have to have some kind of "access", or a way for the blood to come out of their body, go through a machine, and go back into their body. For some people, this is a dialysis catheter that is inserted into the person's chest and looks like this:

It can also be a fistula. A fistula is the surgical connection between a vein and an artery in the arm or leg. Over time, this connection becomes large and rubbery, and each time dialysis is done, two needles (one to remove blood, and one to return it) are placed in the fistula. A fistula often looks like this:

In peritoneal dialysis, the patient instills the dialysate directly into the sac that holds their abdominal organs. The sac itself acts as the membrane, and dialysate draws the electrolytes, water, and waste directly through the sac wall. They then wait a certain number of hours, and drain the dialysate. This can be done manually by the patient during the day, or at night while the patient sleeps with a machine called an automatic cycler. Usually peritoneal dialysis is done every day, with 2-4 cycles of 4 hours per cycle.

People using peritoneal dialysis also need a form of access, but instead of it being to their blood stream, it is to their peritoneum. Here's what that looks like:

The catheter is placed surgically into the peritoneum, and stays there all the time, even in between dialysis sessions.

Someone using peritoneal dialysis has to be very careful when they are accessing their dialysis catheter. This is because the biggest problem with peritoneal dialysis is the risk of a life threatening infection called peritonitis. Someone who gets peritonitis too many times may need to switch to hemodialysis.

Here is what a manual exchange looks ilke:

Someone may choose to do peritoneal dialysis over hemodialysis because it affords more freedom to keep a job or do daily tasks like keeping house. People who do PD also don't have to find rides to the dialysis center. However, they do have to take on more of the responsibility for making sure they do treatments correctly and be able to keep accurate records of the treatments they give themselves. Peritoneal dialysis also tends to be less taxing on the body, and have fewer side effects than hemodialysis when done correctly.

[dramarec]

I did not have annoying medical inaccuracy on my bingo card for this week's episode of My Stand-In, then again I don't know what I've expected. Inaccuracy is like the Spanish Inquisition. Bane of my existence, the thorn under my nail.

Joe's mom gets hospitalised due shortness of breath. The doctors diagnose pulmonary oedema, caused by end stage renal disease / kidney failure. So far we're good, and I appreciate chosing something outside the usual cancer/heart disease pool.

But then the doctor tells Joe, that his mother has septicaemia and requires lifelong hospital treatment to stay alive.

First of all, what an ESRD patient has is called uraemia not septicaemia. Those are very different things. Idk if the mistake is on the scriptwriter's part or on the translator's, and I'd be grateful if someone who spoke Thai could tell me!

Second of all, dialysis is usually done by outpatient treatment! Although Joe's mom would have to visit a dialysis station every three days for the rest of her life, she would be able to live her life outside of the hospital! And that is without considering alternative treatments like peritoneal dialysis or a kidney transplant.

The two options for my second points are either the Doylist bad writing (bleh) or the Watsonian the doctor is trying to scam Joe. Which is ridiculous, but in this series, a crazy sublot like this might fly...

[fromkenari]

Here's something that I doubt everyone knows about the disability crisis in the United States. For a civilian to get disability payments, they have to be "totally" disabled; in other words, you have to prove you cannot get any job in any industry based on Department of Labor statistics in your state, not *just* that you have a debilitating condition. For a veteran to get disability payments, they have to prove a percentage of how disabled they are, and getting 100% disability as a veteran is no easy task wording is critical in the documentation if anyone at any point in your medical history intentionally or not downplays your disability you will get percentage points taken off how much pay you get as a disabled veteran. This is particularly difficult for people with any pride or dignity left because, in both civilian and veteran cases, you must explain just how awful it is in explicit terms and quantifiable, dehumanized ways to sate the court's interest, or you will not get "total" disability. Furthermore, until you are considered "permanently" disabled, you must repeat this process every 3-5 years. Yet, again no one anywhere can talk about you improving or you're out (for civilians), or your disability percentage amount is reduced (for veterans.) Also, if you manage to prove a "permanent" disability, you still get checked every seven years to make sure it's still "permanent." Finally, to get your student loans discharged as a civilian, you must prove your disabled status is both "total and permanent," guess what if one of those changes? Those loans come right back. Also, your loans go into forbearance if you're" totally disabled" and not considered "permanent" or "short-term" (more than 2 weeks, up to a year). Yes, that is the one that accrues interest. Not deferment. For short-term disability, you can defer, but if you're long-term, non-permanent, you forbear. Most people on long-term disability are medically permanently disabled but not in the eyes of the law because of their age, even if it is a chronic or progressive disease. This is why people die waiting for total disability, let alone permanent. My disability attorney said straight to my face 10 years ago, "You should get disability because you have a chronic disabling condition in two systems, but it's going to be a fight because you are so young." I was 28, by the way. She said if I had "just Lupus" or "just medication-resistant dysthymia and generalized anxiety," I wouldn't have stood a chance. My cousin "just" had Lupus and was in end-stage renal failure, it took her 3 years to get disability, and by then, she had a kidney transplant. She was in her 20s and on her parents' insurance. I have a friend whose veteran husband couldn't get 100% VA disability because some doctor at some VA clinic years ago had written down "mild back pain" when describing the pain he felt from degenerative disc disease and 2 herniated discs. It took years to get that one note out of his file. No matter what any other doctor said. So when I say you can't comprehend the disability crisis in the United States, I'm talking about this. Thanks for coming to my TED Talk.

[superflaminggayelmo]

I have a headache and I wish I could take naproxen instead of useless Tylenol