Beginning Hemodialysis, Take Control!
Living with hemodialysis is life-altering. To maintain a healthy life with quality we need to learn as patients and caregivers the tips on how to better work with your healthcare team.
10 Tips for a Good Life When You Have hemodialysis
Your life may be different with hemodialysis, but you can still enjoy it. Below are 10 tips to help you enjoy a good life as your lifestyle changes:
Learn all you can about hemodialysis and especially your own condition. Become a partner in your care to help you live long and well with hemodialysis.
Learn about your medications, their proper dosages, names and the purpose of each one.
Track your lab test values over time and learn what they mean.
If you don't understand something, Ask questions. Talk with your doctor.
Work with your health care team to determine good.
Regular muscle building exercise and walking.
Find out what your target blood pressure should be and work with your doctor to do what you must to keep it there.
For the diabetic patients blood sugar control is very important in reducing complications to the heart, eyes and nerves.
Learn about transplant, pay attention to the doctor’s advice on following up with the closest transplant center.
Cultivate an appreciation of life; do those things that are most meaningful and bring you the most joy.
Medical screenings for people on dialysis
Here are a few lists of what you can expect from a routine medical screening, depending on your age and gender.
Age 18-39
Age 40-64
Age 65 and older
Disclaimer: The information shared on our websites is information developed solely from internal experts on the subject matter, including medical advisory boards, who have developed guidelines for our patient content.
References:
1. https://www.mentalhealth.org.uk/a-to-z/p/physical-health-and-mental-health
According to the Center for Disease Control (CDC), heart disease is the leading cause of death in the United States and stroke is the third leading cause. Both of these conditions are caused by cardiovascular disease. Cardiovascular disease is common in people with chronic kidney disease (CKD) regardless of age, stage of kidney disease or if they’ve had a transplant. In addition, underlying conditions that cause renal disease, such as high blood pressure and diabetes, put people at risk for cardiovascular disease.
What is Cardiovascular Disease?
The adult human heart is about as big as two clenched fists and weighs about 11 ounces. It pumps oxygen and nutrient-rich blood through the arteries to vital organs, including your brain and tissues. Cardiovascular disease (CVD) is an umbrella term used to describe conditions that affect the heart and blood vessels (also known as the vascular system).
Cardiovascular disease can affect the function of the heart and the blood vessels, leading to serious health problems. A breakdown or interruption in oxygen supply to your organs will cause damage and possibly death. If you suffer from CVD, life-sustaining organs like your heart and brain are at risk.
Many chronic kidney disease patients suffer from heart disease, which is a type of CVD. Heart disease is a general term to describe any cardiovascular disease that affects the heart and/or the blood vessels in the heart. The following conditions are considered heart disease:
The following types of cardiovascular diseases that affect the blood vessels may impact people with renal disease:
Chronic kidney disease and the risk of cardiovascular disease
Complications that develop from chronic kidney disease, as well as the underlying conditions that cause chronic kidney disease, can put you at risk for cardiovascular disease. The following are complications that develop from renal disease and can lead to cardiovascular disease:
Diabetes and high blood pressure are the two leading causes of kidney disease. Here is how each can affect your heart and lead to cardiovascular disease:
Treating Cardiovascular Disease in people with kidney disease
Whether your cardiovascular disease is caused by complications of your kidney disease or by the underlying cause of your kidney disease, it's important to be aware of the impact it can have on your overall health. Treating the cause of your cardiovascular disease and keeping other conditions like chronic kidney disease, diabetes and high blood pressure under control will help you feel better.
Your kidney doctor will monitor the health of your kidneys and check for signs of cardiovascular disease. You will also be monitored for complications like anemia and high blood pressure. Part of your treatment program may include taking certain medications to treat these complications, as well as treating any calcium or phosphorus imbalances in the body. Your doctor will also refer you to a renal dietitian, who will work with you to create a kidney-friendly and heart-friendly diet that is low in cholesterol and saturated fats.
If you have diabetes and/or high blood pressure, your kidney doctor will work with your family doctor and renal dietitian to treat both conditions. Your treatment plan may include a combination of medication and diet. Managing your diabetes and blood pressure levels in the early stages of kidney disease will help slow the damage to your kidneys as well as reduce your risk for cardiovascular disease.
Your doctor may also recommend exercise as part of your treatment program. Based on your physical condition, age and other factors, your doctor will suggest activities that are right for you. If you smoke, your doctor will recommend that you stop. Smoking increases your risk of cardiovascular disease, and can cause other complications.
Chronic kidney disease affects more than your kidneys; it can put vital organs such as your heart at risk. Managing your renal disease and the underlying causes of your kidney disease, such as diabetes and high blood pressure, can reduce your chances of developing cardiovascular disease.
https://www.davita.com/education/kidney-disease/symptoms/chronic-kidney-disease-and-your-heart
Check in During your first visit to your DaVita center, you will meet the “crew” that will always be here for you. You will be assessed by a doctor, a nurse and a social worker, who will translate everything for you. You will get a lot of information, so it is a good idea to bring a family member or friend to this first meeting. A lot is changing in your life. It is normal to feel overwhelmed at first, even sad, but don’t worry. Our team of experts will support you through every step of this new journey. If you are feeling afraid or sad, your social worker and other members of your care team are always here to help. Please bring all your documents, medications and questions to your first check-in. HOW TO USE THIS BOOK As you begin your kidney care journey, think of each step as a “station” that gets you closer to your destination—to live well and feel healthy. As you reach each station, we will cover more detailed information as outlined in this book. So let this book be your travel guide, the notes pages as your travel journal, your care team as your travel crew, and your healthcare journey as an adventure. Together, we’ll help you understand how your body works and how your everyday choices can help you feel healthier. At DaVita, our goal is to make this journey as comfortable and as pleasant as possible. We will be here for you every step of the way. You will have lots of questions as we cover new ground. Please don’t ever hesitate to ask. We are happy to answer any questions you may have. In this travel guide, you will find:
• Your carriage information (clinic information) and your assigned seat (shift, schedule and care crew)
• Your travel instructions: what you need for your journey/treatment
• Your journey: before, during and at the end of the treatment
• Between journeys (treatments): what to think about
• Traveling with your team
• Tips for the trip
• Emergency evacuation
• How are we doing?
• Next stations Your Carriage Information UNIT NAME OPENING HOURS ex: Saturday – Thursday 7.00AM – 9.00PM TELEPHONE NUMBER Your Assigned Seat PATIENT NAME YOUR TREATMENT TIME IS ex: Saturday, Monday, Wednesday 7.30AM YOUR CREW (ex. Patient Relations) (ex. Contact Nurse) (ex. Doctor) (ex. Dietician) (ex. Social Worker) If you need to get in contact with us when the unit is closed, please call: Your Travel Instructions Things to pack
• Your medications
• Something to entertain you during the treatment such as a book, tablet, music device (and headphones)
• Wear loose clothing that can be rolled/unbuttoned to expose your access
• Small blanket and pillow (if desired)
• Any questions you may have Additional assessments During your first week we will make additional assessments and give you information. They will include:
• Blood samples—even if these were taken recently in your previous clinic, we usually need to do some samples on admission day
• A full medical, nursing, social work and dietetic assessment to prepare your plan of care
• Assessment of current transplant status
• Assessment of current vaccination status
• Informed consent, on admission
• Patient rights and responsibilities
• Information on emergency evacuation Before the Journey Once you arrive at your clinic, a nurse will take your temperature, weigh you and ask some standard questions. A doctor will examine and talk to you. It is very important that you tell the staff if you do not feel well. The triage examination performed when you arrive in the clinic is to protect you and others from MERS (Middle East Respiratory Syndrome). Please answer all questions truthfully and let our staff know if you have any symptoms including: cough, breathlessness, fever, body aches, nausea, vomiting, sore throat, headache, runny nose, diarrhea.If you bring a family member or friend who will enter the clinic with you, they must sign in to the visitor register, have their temperature taken and answer the same questions. They must also follow some basic clinic rules that help protect you, them and others from the risk of infection, which we will address later in this guide. To protect others from the risk of MERS:
If you need to cough or sneeze, cover your nose and mouth with a paper tissue. Throw the tissue into a wastebasket and clean your hands with alcohol gel. Before your treatment: There is one male and one female waiting area. You may rest in the waiting area while your treatment is prepared for you. A nurse will bring you into the treatment area when ready. It takes some time to prepare your treatment, and to finish the procedure after your treatment is completed. Make sure to allow enough time (30-45 minutes) over and above your prescribed treatment time.
Everyone who enters and leaves the treatment area—patients, visitors and staff—must clean their hands with the alcohol hand rub available at the entrance to the treatment area. Alcohol hand rub is also available at each dialysis station for the use of patients, visitors and staff. Before you begin your treatment, you will be assessed. A teammate will measure and record your weight, blood pressure and pulse, if it was not done already during the triage assessment. During the assessment, we may ask you questions like how you are feeling, and whether you have shortness of breath, cramps or dizziness since your last treatment. Your legs, arms and tummy might be checked for swelling. Sometimes we also need to listen to your lungs. This is to make sure we can remove the right amount of fluid from your body so that you can feel better. It is very important that you comply with your care team’s instructions on salt and fluid intake, as this helps ensure you come to dialysis without too much extra fluid (weight). Having a lot of extra fluid can make you feel sick during the treatment. See Station Eating for Life for more information about fluids and salt intake. VASCULAR ACCESS Vascular access is the entry into your bloodstream that allows dialysis to happen. You can have one of two types: an arteriovenous (AV) access or central venous catheter (CVC). Specific safety recommendations are based on the type of vascular access you have. These important steps help protect you from infections and complications. If you have an arteriovenous (AV) access, it is important that you wash your arm carefully with soap and water before the treatment. This helps remove some of the bacteria that normally gathers on your skin. An experienced nurse will put needles in your access and connect you to the dialysis machine. See Station Vascular Access for more information. If you have a central venous catheter (CVC), a sterile procedure will be used during connection and disconnection to the bloodlines of the machine. You and your healthcare team must also wear a mask during these procedures to prevent infection. They will ask you to turn your face away from the catheter but in a comfortable position. See Station Vascular Access for more information. At this time, blood samples may be taken from your vascular access. Then you’ll be ready to start your journey. Your treatment will last about four hours.
The machine will pump your blood around in a closed circuit through a filter (dialyzer) that does the work of a kidney. The machine will clean your blood, take out the fluid you have collected since your last treatment, and give you the right salt balance. To work effectively, the treatment needs to run for a certain time, and you need a minimum amount of treatments per week. Studies have shown that, to stay healthy, hemodialysis patients should have a minimum of four hours three times per week. This is why the Ministry of Health asks DaVita to provide you with treatment of no fewer than four hours. But your doctor may prescribe a longer treatment time if it is best for your personal needs. SECURITY CHECK! It is important for your health that you come to every treatment, and it is important that you can stay for the entire treatment session. Every minute counts! Some people can feel some discomfort during treatment, like dizziness or cramps in the legs. It is very important that you tell your care team if you feel unwell. For your safety, keep the curtains open during your treatment so that the team can see you are well and safe. During the treatment you can relax, read, socialize or watch TV. Nurses will check with you frequently to make sure everything is OK during the treatment. The vascular access should be always uncovered during the treatment so your care team can easily see if something is wrong. You will also be offered something to eat and drink. You need to discuss with the care team how much you will have, since this should be added to the fluid loss goals for your treatment. The more you want to drink, the more fluid needs to be taken off during the treatment—and the more chance that you will have complications like low blood pressure. So it is important that you get the balance right!
When your treatment is finished, the nurse will disconnect you from the lines of the machine and provide you with final care and assessments. If you have an AV access, the needles will be removed carefully and you will be asked to apply some pressure on the needle removal sites. We ask you to wear a glove during this procedure. Once the bleeding stops and a plaster or a dressing has been placed on the access sites, you may go home. The dressing can be removed a few hours after you leave the center. See Station Vascular Access for more information. If you have a CVC, the tubes will be flushed with sterile solution, disinfected, closed, and a dressing will be applied. The dressing should be kept intact, clean and dry until the next treatment. See Station Vascular Access for more information. After treatment, we will measure your weight, blood pressure and pulse again. This lets us know that all is well before you leave for the day. Now you are ready to go. Don’t forget! You must clean your hands with alcohol rub after leaving the treatment room. It is important that your relatives/friends do the same. Some people feel tired after the treatment, so it is good if a family member or friend can bring you and take you home. Please contact your care team any time you feel unwell, and refer to the Emergency Department if needed. Things to Think About Between Your Treatments YOUR VASCULAR ACCESS—YOUR LIFELINE When your treatment is finished, the nurse will disconnect you from the lines of the machine and provide you with final care and assessments. If you have an AV access:
• Feel the thrill every day (your nurse will show you how).
• Do not sleep on your access arm. Do not wear anything tight on the arm.
• Do not lift anything heavy with your access arm.
• Keep your access clean and dry.
• If it starts to bleed after dialysis, put pressure on it for 15 minutes with a sterile gauze pad (if possible). If it does not stop, go the nearest hospital. See Station Vascular Access for more information. If you have a CVC (central venous catheter)
• Keep the dressing on and touch it as little as possible.
• Do not swim with a CVC or take baths.
• Be careful with showers; the bandage or dressing should not get wet.
• Keep the bandage or dressing clean and dry.
• Wash your hands often.
• Contact the clinic if you feel you have a fever, even if slight. See Station Vascular Access for more information. drinking
• Be very careful about how much fluid you drink. Try not to eat salty foods that will make you thirsty. Your weight gain between treatments will be the amount of fluids you take in, and too much extra fluid is bad for your heart. Remember that some vegetables and foods such as soup, ice cream and popsicles count as fluid too.
• Drink no more than 250 ml per day. See Station Eating for Life for more information. EATING
• You can eat: ex: eggs, meat, fish
• Be careful with: ex: cheese, milk, yogurt
• Be very, very careful with: ex: dates, chocolate, bananas, soda or other sugary carbonated beverages See Station Eating for Life for more information about diet. Security check! Stay active and try to do all the things that bring you joy and help you keep a positive outlook. Traveling with Your Team
• Remember, you are not alone! Share your concerns with your care team. There are many people around you willing and able to help you (your care team, family, friends, other patients…)
• We are here to help you. Don’t hide away your feelings and thoughts. Ask for help.
• Ask questions. Get more information about what is happening with you. This will help you take charge of your life and your health.
• Read your travel book. Be eager to learn more. Knowledge will help you understand and overcome any challenges.
• Make sure you understand what is being explained to you. Ask us to repeat anything, as many times as you need.
• Share with people around you. It is the only way you can get the support you need.
• Be positive!
• Help other people at dialysis. Use your experience to help other patients. This will help you, too!
• Stay active and live a normal life. Don’t let kidney disease define you. Keep your life full as much as before. Ask your care team how you can adapt to keeping your job, going to school, driving, exercising and vacationing without any problems. Tips for Trips: Our goal is to make “travel time” for you, and everyone else who is on board, as pleasant as possible.
• Come to every treatment. Make sure you allow enough time for the connection and disconnection, in addition to your treatment time.
• Be triaged as soon as you enter the clinic, to protect yourself and the others from MERS CoV.
• Stay for your entire treatment. Every minute counts!
• Wash your hands often.
• Cover your nose and mouth when coughing or sneezing.
• Be helpful and kind to your fellow patients.
• Be helpful and kind to the teammates who work here. Your Traveling Companions Your relatives, family or friends are always welcome in our center. So we can maintain the safest environment for your treatment and care, we ask that you and your guests follow these rules: To reduce infection risk, anyone who will accompany you to the treatment should:
• Request authorization to enter the clinical area
• Be fully triaged for MERS-Cov
• Clean hands with alcohol gel before entering and leaving the treatment area
• Clean hands with alcohol when moving away from your dialysis station • Not eat, bring or share food in the treatment area
• Should not move any objects or food between patients
• Should wait outside the clinical area during connection and disconnection or other specific care activities
• Show respect and kindness to other patients
• Show respect and kindness to the care team
• Use the waiting room or other designated areas to pray
• Follow the recommendations on how to cough and sneeze, using always a tissue, discarding it and cleaning their hands.
• If you are coughing or sneezing, ask for a mask and stay in the waiting area. Following these rules will help us all stay healthy! Emergency/Fire Evacuation In the unlikely event of any emergency evacuation, is very important that you know:
• Where fire exits are located
• Where the meeting point is
• How to evacuate safely This will be explained to you during your first day’s appointment. Your care team will tell you how to follow this procedure when the alarm sounds, or you receive a notification of emergency.
• If you are not connected to the machine, leave the area immediately by the nearest exit.
• If you are connected to the machine, wait for the nurse to disconnect you and instruct you to leave the room.
• Proceed in an orderly manner to the assembly point.
• Don’t use the elevator or lifts.
• Do not take risks.
• Do not stop to collect personal belongings.
• Remain at the assembly point until the all-clear is given.
• Do not re-enter the building without authorization. Enjoying Your Journey: How Are We Doing? In order to offer you the best “travel” experience possible, we need your help. From time to time we will ask you how we are doing. Your honest answers are essential to ensure that we keep improving. Anytime you have complaints, suggestions or comments about our team, please tell a member of your healthcare team. Discover tips and resources on how to stay healthy at our recipes page.
