New Patient Dialysis Program

1. New Patient Dialysis Program Anthony Wallace, CALA, ND P.C.D.I. Healthcare and Consultants of Texas L.L.C.

2. Introduction • This power point presentation will educate patients and caregivers on the importance of proper eating habits to prevent dialysis. There are factors that can not prevent a patient from becoming a dialysis patient. • I caution any consumer or medical personnel using this information to educate themselves must consult their licensed MD (Medical Doctor) or licensed (ND) Naturopathic Doctor when adding the information used to developed this power point presentation. • It is always a good standard of practice to inform your doctor or practitioner of any alternative practices used. This will ensure that the two practices will not contradict one another. • Most alternative methods may interfere with conventional medical techniques and may result in set back in care or death.

3. Terms of Dialysis • Dialysis - To extract urea from urine • Dialystate – The “water” used for dialysis (bicarbonate and acid) mixed together and pulled through a line in the walls and hooked to the dialysis machine to filtrate the patients blood. • Dry weight – is the assumed weight before the patient was placed on dialysis or before dialysis procedure. • Urea – is the substance (toxins) that has not been filtered by the kidneys. • Kilos – refers to the water or excess toxins that has accumulated in the patients system. This is cause weight gain and also determines how much time the patient will need to be on the machine. This can be corrected by diet. • To dry – this means that the patient has had to much kilos taken off and will need IV saline to hydrate the patient. • To wet – this means that the patient will need extra time on the dialysis machine to pull excess water from the body. • ESRD – End stage renal disease

4. Terms of Dialysis • Urine – is the finished product of the kidney process and is expelled out of the body. • Renin – is a proteolytic enzyme secreted by the kidneys • Creatine – is the by product of kidney function. It is the breakdown of muscle. • HBV - High Biological Value (eggs, milk, chicken, and fish) • nephrons - Kidney cells • Glomerulus – is a cluster of capillaries in a capsule. • Uric acid – the natural breakdown of cells in the body • Brill – is the what the practitioner may hear with a stethoscope • Thrill – is what the practitioner may feel to make sure the access is working. • Access point – it is the shut either in the arm or the neck.

5. History of Dialysis • Dialysis was first discovered by Thomas Gram • In 1913, the first artificial kidney was constructs. This picture is an example of the kidney. • 1943, William Kolff constructed the first working dialyzer. • In 1946, Niles Alwal produced the first dialyzer. • In 1948, the parallel plates dialyzer was developed • 1960, kiil developed a simpler countercurrent flow method with parallel flow (red to blue)

6. Peritoneal Dialysis • Peritoneal dialysis is a form of dialysis that is done in the patients home. • This blood filtering procedure requires at least one other person to be at home with the patient in case of an emergency. • The patient infuses Dialystate into there bodies through an artificial surgical port. • The solution then sits in the body for an hour then is excreted through the same port into the sterile bag. • Complications may include weight gain and infections.

7. Hemodialysis • Hemodialysis is a procedure that most patient will be placed on because of ESRD (end stage renal disease). • Hemodialysis is a form of therapy that pulls blood from the patients body and artificially filters it as the human kidney would do. • Most patients that are on dialysis regularly visit the dialysis center 3 times a week and are placed on strict diets to prevent complications. • Most patients that are on dialysis are on it as a result of diabetes, hypertension (high blood pressure), or acute renal failure recreational drug use.

8. Complications of Dialysis • The common complication for dialysis patient are aneurysm under the skin. • Aneurysm mainly come from practitioners error. Sometime the patient may want to be dialyzed in the same spots because of the pain associated with inserting new spots. It is when the practitioner is inserting the needles into the same spots over a period. The practitioner must rotate sites. • Sometimes the patient may be extremely fatigued (no energy) that may be due to the loss of blood protein

9. Complications of Dialysis • The most complication in dialysis is cramping, nausea and vomiting, loss of consciousness, anorexia, clotted access ports, lost of blood pressure, aneurysm, and death. • If you experience any of these symptoms please call 911 or the dialysis center for guidance.

10. Dietary Preventions • Dialysis patients are placed on strict diets regarding liquid and the types of food that they can eat. • Water is essential to health and may be restricted because of the impaired kidney function. Fluid permitted varies with each patient. • It is recommended that the patient consumes 5-6 small meals daily • The acid ash diet – lower phosphorus levels in the body and is issued for those that are having issues with kidney stones. • Acid ash diet can be used ad a preventive also such as oranges, lima beans, olives, bananas,

11. Resources • National kidney foundation, www.kidney.org • World Health Organization, www.who.int • American kidney Fund, www.kidneyfund.org • National Kidney and Urological Disease Information Clearinghouse http://kidney.niddk.nih.gov

12. References • Health wise, uric acid in the blood, 2010 • Ed Ren, www.renux dmed.ed.ac.uk , 2011 • Mayo clinic, peritoneal dialysis, 2011