Is automated peritoneal dialysis recommended?

Many patients who need a dialysis treatment to control kidney failure must decide between two options. The first one, best-known as ‘hemodialysis,’ is the first image that pops into the minds of people when it comes to dialysis. This procedure consists of connecting the patient to a machine that fulfills the same functions as the kidneys: filtering the blood and eliminating the excess of fluids from the body. For this reason, it is necessary that patients go a couple of times a week to a hospital or to a specialized center, and lay down while the machine does its work. This is not the only option, though. There is also peritoneal dialysis. Despite this treatment does not differ essentially from hemodialysis, offers certain conveniences to patients that hemodialysis cannot allow. One of them is that patients do not have to plug into a machine or move to a hospital for doctors to monitor their health status.

Automated peritoneal dialysis is fundamentally not different from traditional peritoneal dialysis. This system uses the same type of catheters, and the kidney function is carried out in the same way. The difference is related the way in which the process is carried out. In automated peritoneal dialysis, a machine controls the development of the renal function. This means how much liquid gets into the bag and is ejected when the filtration process is over. In this way, patients do not have to worry about how much liquid they have added to the bag, and the machine is responsible for reminding patients when they should start a cycle in advance.

The filtering process takes about eight hours, but it may extend to ten, especially when patients are sleeping. One of the functions of the machine, in addition to calculating the amount of liquid that gets into the bag, is measuring the time of infusion, permanence, and drainage, and in a very safe way, which gives a lot of peace to both patients and doctors.

Read also: Dialysis most common complications, by Joe Cosgrove

The machines used for this procedure are not large. The biomedical engineering that has worked been behind the studies of automated peritoneal dialysis has made these machines fit in a small suitcase, which, although it may be heavy, has wheels and can be carried anywhere. The machine can be used almost anywhere (an airplane, for example.) One of the great advantages of this system is that the machine keeps a record of the activity from the beginning of the treatment, which can be observed by the doctor even without the patient moving to the hospital. This system is connected to the Internet. This means, in a few words, that the machine is permanently gathering information from the patient and transmitting it through the cloud. The doctor only has to use a device with an Internet connection to check the patient’s condition (it may be an app in his or her smartphone.)

The latter is a great advantage for doctors because the patient does not have to make any report. The system is responsible for producing the necessary information for the doctor to evaluate the patient’s conditions. Even some software systems are designed so that the machine tells the doctor if the patient is presenting problems that must be resolved urgently (the first symptoms of peritonitis, for example) and that patients may not detect in time, meaning this a great danger to their health.

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Image courtesy of Amber Case at Flickr.com

Automated peritoneal dialysis, in addition to being very useful for the health of patients, is also useful for medical research in this field. Because the number of patients suffering from kidney failure increases every year, doctors are very concerned about finding new ways to solve this problem. For this, it is tremendously important to have a large amount of information available.

Some doctors wonder if this system is recommended. The truth is that it is. There are studies showing that automated peritoneal dialysis is related to a much higher survival rate than the traditional peritoneal dialysis system. The reason for this is that the machines can calculate much more accurately the amounts of liquid that the patients need, as well as the filtering and expulsion times. The medical community knows that the more customized the treatments, the results will be much better since every organism is different and may react differently to the general conditions of any treatment. This is the case. On the other hand, one of the main problems that occur in peritoneal dialysis are infections, which has been resolved in a large percentage thanks to automation and its monitoring. The behavior of blood pressure is also another problem, and the study mentioned above shows that medical science is ready to reduce this issue to almost the minimum. There is still much to be discovered in terms of peritoneal dialysis, but the truth is that it is progressing so fast thanks to the data provided by patients. Let’s hope for the best.

Recommended: Do Automated Peritoneal Dialysis and Continuous Ambulatory Peritoneal Dialysis Have the Same Clinical Outcomes?

* Featured Image courtesy of Franck Genten at Flickr.com

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Exercise during dialysis: an option you should really consider

Many people believe that dialysis is the end of many aspects of life, and it is not. Thousands of people manage to continue with their normal lives. These people suffer a permanent condition and need particular care, though, but it is possible to live with dialysis. An evidence of this is the wide number of athletes who have shown the world that it is possible to get ahead in these harsh conditions. Sean Elliot, Ed Hearn, Paul Hutchins, Donald Jones, Chris Kemoeatu … they know what you have been going through, and they have found ways to get ahead with sports. In addition, they have also helped the medical community a bit. It is known that exercising is very helpful during dialysis, which was previously considered unthinkable, both for patients and doctors.

In this post, we will talk about exercise during dialysis treatment. In addition to the benefits, what exercises could you do to improve your health conditions?

According to an article from the Journal of Physical Therapy Science (2017,) dialysis patients who exercise daily have a better quality of life and suffer less risk of getting worse and dying. Actually, exercise favors circulation and oxygen levels in the blood, helps food to be processed better, improves the mood of patients, strengthens the immune system, benefits the quality of sleep, and, above all, increases the effectiveness of dialysis because the filtering of blood is much higher.

This knowledge is not new. In fact, more than three decades, it is already known that exercise brings great benefits for patients with renal failure. What has happened is that the knowledge about this was not extensively widespread during all these years. Now it’s a trend, and, by the way, most doctors advise patients with kidney failure to exercise on a daily basis (including elderly patients.)

The main concern that arises, especially in the case of athletes, is related to food. An athlete needs a greater amount of energy than a sedentary person, and the problem is that some of the foods that provide this energy may be counterproductive for a kidney failure patient. Meat, for example. An athlete needs a greater amount of protein, but patients with kidney problems should be very careful with purines. For this reason, it is highly advisable to listen to the considerations of dietitians in these cases.

So, what exercises are recommendable, then?

Along with any exercise of your choice, from basketball to yoga, and snowboarding, these indoor and outdoor exercises could be an excellent alternative for you:

Aerobics

Aerobic exercise, unlike others, is not designed to beautify muscles, but to strengthen the cardiovascular system. Unlike most gym routines, these exercises do not seek to develop the strength of the muscles, but rather their resistance. These are the exercises that consume more body fat and which provide a greater amount of oxygen to the bloodstream. An additional benefit of aerobics is that they help the body to release a lot of endorphins, which is quite positive for patients with renal failure since depression is quite common in these cases.

Read also: Dialysis most common complications, by Joe Cosgrove

Tai Chi and Martial Arts

Strength exercises are also very beneficial. For this reason, if you want to combine aerobic exercise with strength exercises, martial arts are a must. Besides that they will help you to attain discipline, you will have belt-challenges to stay motivated. Martial arts usually consist of really complete exercises. Kung-Fu, Taekwondo, Karate, and Jiu-Jitsu: all of them are wonderful.

However, if you consider yourself a less explosive person, Tai Chi is a good option. Although Tai Chi began as an attack and defense system in the past, it gradually became a meditation in motion which is tremendously beneficial for the health of the body and the mind.

Swimming

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Image courtesy of Pixabay at Pexels.com

Swimming is one of the most recommended exercises by doctors, and for several reasons. One of them is that in the cold water of a swimming pool, your muscles will work with more effort and this allows not only to burn more than five hundred calories per session but to strengthen the muscles and the immune system. Swimming delays aging improves the lung capacity of people (a regular session of swimming is an excellent aerobic exercise) and strengthens the lung capacity which translates into higher levels of oxygen.

Wim Hof Method

You probably do not know the ‘Iceman,’ Wim Hof, the creator of a very interesting therapy that has broken paradigms in medical science for its interesting findings. Wim Hof is able to withstand ice-cold temperatures for ninety minutes, to run a marathon in a desert without drinking a drop of water, and to keep his breath for ten minutes under the water. He has achieved it with a lot of work, and now he teaches in seminars and apps. Although it sounds fake to skeptics, the Wim Hof method not only strengthens the immune system in a very powerful way but also helps patients to control their anxiety. The system consists of a series of breaths repetitions, flexibility exercises, and icy water dives (just judge yourself.)

* Featured Image courtesy of Pixabay at Pexels.com

Dialysis most common complications

The procedure known as dialysis has been created so that the elimination of toxins and the excess of liquids in the body is possible; a function that, in healthy patients, carries out the renal system (kidneys, in particular.) Even though dialysis is so far the best-known option to treat kidney disease, and despite the fact that the biomedical technology makes all its efforts in considerably improving this system, it is still not possible to execute processes of error-proof dialysis. Unfortunately, complications can occur during the process, which can even negatively affect the health condition of patients. In this post, we will talk about the most frequent complications that can occur during dialysis.

In extracorporeal dialysis, the processes in which blood is removed from the body, complications are not as common. However, it is possible that an arteriovenous fistula infection may occur. Since the fistula is punctured three to four times a week to purify the blood, the risk of infection by bacteria in the puncture site is high. In addition, there is the possibility that thrombi form that obstructs the blood vessel and renders it unusable for dialysis. However, as a general rule, a surgical intervention allows the thrombus to be removed and the fistula to be unblocked.

In peritoneal dialysis, in which the blood is purified inside the body, there is a risk of inflammation of the peritoneum. Bacteria enter the peritoneal cavity through the catheter and cause a painful infection that, under certain circumstances, may endanger the life of patients. Normally, this inflammation responds well to treatment with antibiotics, but sometimes it is not that simple.

People with severe kidney disorders and kidney failure must pay great attention to their diet since many of the complications suffered by dialysis patients are related to food. Since the kidneys are not able to carry out their function of purification and excretion, in many cases those affected can only drink a limited amount of liquid. In addition, they must be careful with the contribution of protein and potassium, since an excess of these substances may lead to serious metabolic disorders in dialysis patients.

Read also: Baxter ShareSource System: A New Dialysis Option for You, by Joe Cosgrove

People with impaired renal function often have a high concentration of phosphate in the blood which may cause damage to blood vessels, such as arteriosclerosis. When the concentration of this is too high, despite having a low phosphate diet, so-called phosphate binders are helpful, they bind to the phosphate ingested with food in the gastrointestinal tract and are subsequently excreted. There are various types of phosphate binders, for example, containing aluminum or calcium, or free of both, which effectively improve the altered balance of minerals in dialysis patients. According to recent scientific findings, it seems that calcium-free phosphate binders are the ones that cause fewer side effects. Nowadays, the use of phosphate binders with aluminum content is no longer recommended due to the adverse effects that they may cause. A treatment with this type of medicine – for many years – may produce an accumulation of aluminum in the brain and bones which leads to worsening brain function and movement limitations.

In order to prevent possible infections of hepatitis B and C, and even HIV, through dialysis, the medical centers in which this treatment is carried out meet the strictest hygienic standards for the cleaning of dialysis machines. People suffering from these type of infections are treated in their own dialysis machines which are not used with any other patients. In addition, active vaccination against hepatitis B is recommended to all dialysis patients.

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Image courtesy of Pixabay at Pexels.com

There are other complications related to hemodialysis. Intradialytic arterial hypertension is less frequent than arterial hypotension, but it has relevant prognostic implications. Fever and chills in patients on hemodialysis should be attributed to endovascular infections, especially in those who have vascular access through a high-flow venous catheter. Likewise, fever at the end of the hemodialysis treatment is suggestive of endovascular infection.

On the other hand, hypervolemia is a complication that occurs regularly. This happens when the patient consumes more fluid than the one he manages to eliminate thanks to dialysis. Hypervolemia can also develop in response to sodium retention in the body due to impaired electrolyte excretion. In nephrological practice, hypervolemia due to sodium retention is observed in acute ophthalmic syndrome, in the oliguric phase of acute renal failure, due to the consumption of large amounts of fluid and obstruction of the urinary tract with volume-dependent hypertension. This problem usually leads to weight gain, and, when not treated in time, can be deadly because heart failure may occur.

Taking into account that during the last decades there has been an increase in cases of renal replacement therapy for different diseases, and, additionally, considering the increase in infections that are difficult to treat, mainly due to the widespread abuse of analgesics by professionals and patients who self-medicate (and who do not know how to differentiate a virus from a bacterial infection,) it is vital to know the different treatment modalities in these patients as well as the complications that can occur in practice.

Recommended: Infections in Patients Undergoing Chronic Dialysis

* Featured Image courtesy of Pixabay at Pexels.com