Over 450,000 individuals in the US suffer from kidney failure, and the National Institute of Health estimates that 20 million Americans suffer from chronic kidney disease.

There are many things that can cause kidney disease. Among the most common are:

• Diabetes
• High blood pressure
• Inflammation
• Blockage
• Chronic infection

Kidney disease is treated with diet, fluid management and medicine. When the kidneys are diseased, waste products and fluids build up and cause weakness or fatigue. There may also be symptoms such as nausea, poor appetite, irritability or decreased mental alertness. For some people, kidney disease progresses so slowly they do not notice any symptoms, for others, it happens very quickly, especially after a serious illness or disease that affects the kidneys. If the kidneys stop working completely this is called kidney failure. Dialysis is the main treatment for people whose kidneys have failed.

Some patients with kidney failure may choose to have no treatment. This is always an option. We provide education and information to these patients and their families and support them in whatever decision they make.

Dr. Bashir bases your medication doses on your laboratory values including PTH, calcium, phosphorus and CAx P product. These labs are monitored regularly and are adjusted as needed based on your response to certain medications. You too can help control your health by limiting the amount of phosphorus foods in your diet, taking your medications as directed, and staying for your full treatment, every treatment. Studies have shown that getting the right amount of dialysis improves your overall health, keeps you out of the hospital, and may enable you to live longer. Our goal is to help you help you improve your quality of life, so if you have any questions or concerns please don't hesitate to ask us questions.

Diabetes

Diabetes is the leading cause of kidney failure. An approximate 25-40% of kidney disease patients have diabetes. There are two types of diabetes, 1 and 2. Type 1 is when your body doesn't make enough insulin. Insulin helps us to use or store glucose from the foods we eat. Type 2 is the most common form of diabetes in the USA . In this case you body makes insulin but your is resistant to insulin's actions or your body may not make enough. Complications include heart disease, nerve, and kidney damage. According to the July 2006 issue of the journal for Diabetes Care, 37,000 women over age 45 who averaged a daily intake of dairy products such as milk, yogurt, cottage cheese, sour cream, ice cream, and cheese had a lower risk of developing type 2 diabetes. Before making any changes to your diet make sure you discuss them with Dr. Bashir or our dietician.

To learn more visit the American Diabetes Association.

High blood pressure

High blood pressure is the second leading cause of kidney failure. Tobacco use increases your risk for kidney failure, many kinds of cancer and heart disease. In order to maintain a normal blood pressure you need to follow your diet. This will help you control sodium, potassium, and other essential electrolytes that your body uses to maintain fluid balance. Monitoring your fluid intake between treatments is extremely important. Removing more fluid increases the rate at which the fluid is pulled out of your bloodstream, which can increase your risk for high blood pressure during your treatment. Taking your medications as directed is also essential for maintaining a normal pressure. Knowing why your pressure rises and falls and how it's treated can minimize your risk. Controlling your high blood pressure may slow or prevent kidney disease.

What does dialysis do?

• Removes waste, salt and extra water to prevent them from building up in your blood.
• Keeps safe level of certain chemicals in your blood.
• Helps control blood pressure.

There are two types of dialysis, hemo dialysis and Peritoneal dialysis (PD). Before you begin Dr. Bashir will arrange for you to have access placed.

There are three kinds of access:

Fistual: This is the most common method of providing permanent access to the bloodstream for hemodialysis. This is a simple procedure which involves having an artery and a vein connected surgically. When they are joined, the stronger blood flow from the artery causes the vein to become larger. Needles can be inserted in the enlarged vein to connect you to the dialysis machine.

Graft: Another way to provide access to the bloodstream is to insert an internal graft. In this procedure an artery is surgically connected to a vein with a short piece of special tubing placed under the skin. Needles can be inserted in this graft.

Catheter: When necessary to gain access to the bloodstream quickly, or when the veins in the arms are too small to provide enough blood for hemodialysis, a central venous catheter is used. A soft tube is surgically inserted into a large vein in the neck or chest. This method is usually temporary until a permanent access site is ready. This access can be connected directly to the dialysis tubes and needles are not used.

Hemodialysis means "cleaning the blood." This is the most common form of dialysis treatment. Two needles are inserted into your vein. One needle is connected to the tubing which takes your blood out of your body to be cleaned. Blood is circulated through a machine which contains a dialyzer (also called an artificial kidney). The dialyzer has two spaces separated by a thin membrane. Blood passes on one side of the membrane and dialysis fluid passes on the other. The wastes and excess water pass from the blood through the membrane into the dialysis fluid, which is then discarded. The cleaned blood is returned to your bloodstream through the second needle. Removing the harmful wastes and extra salt and fluids helps control your blood pressure and keep the proper balance of chemicals in your body.

In PD, a soft tube called a catheter is used to fill your abdomen with a cleansing liquid called dialysis solution. This fluid and tubing is connected to your catheter, which is hung on a pole with wheels. The solution contains a sugar called dextrose that will pull wastes and extra fluid into the abdominal cavity. These wastes and fluid then leave your body when the dialysis solution is drained. The used solution, containing wastes and extra fluid, is then thrown away. The process of draining and filling is called an exchange and takes about 30 to 40 minutes.

The period the dialysis solution is in your abdomen is called the dwell time. A typical schedule calls for four exchanges a day, each with a dwell time of 4 to 6 hours.

Another form of PD, continuous cycler-assisted peritoneal dialysis (CCPD), requires a machine called a cycler to fill and drain your abdomen, usually while you sleep. CCPD is also sometimes called automated peritoneal dialysis (APD). This is good for people who want more freedom from dialysis during the day or who need help with dialysis.