Baxter ShareSource System: A New Dialysis Option for You

Chronic kidney disease is a quite underestimated subject by ordinary people. This issue is much more socially extended than many people believe, and, in fact, statistics suggest that one in every hundred people may be suffering from this terrible illness today. This problem is one of the main public health issues in several countries, not only because of its disastrous health consequences and because of its high frequency in the population, but because the treatments (dialysis, eminently) to respond to this issue are usually expensive. The main consequence when it comes to chronic kidney disease is that the patient must depend on a kidney transplant or a machine to survive in his or her remaining time of life.

The only option for thousands of people around the world is to sit or lay for three or four hours connected to a machine that removes toxins from the blood system. This is the only way to filter out a series of toxins as well as the excess of fluids in the body, which the kidneys eliminate in normal conditions. This is the normal life situation of millions of patients diagnosed with renal failure who cannot afford a kidney transplant, or who, although they can actually afford it, must wait for a donor for years. The process of dialysis, in any of its forms, must be carried out for life. The body has no vacations, after all.

This therapy has two modalities: hemodialysis, which can be performed three times a week in a health center, and peritoneal dialysis, which is done daily from the home of patients, four times a day. Each month, the specialist in charge of the process monitors the treatment and the condition of each patient and, if something is not going well, he or she makes the appropriate changes to improve the therapy.

Since the end of last year, a new technology allows doctors and patients to change that traditional way of doing dialysis (in any of both ways.) We are talking about the ShareSource platform of Baxter International, a system that automatically transmits (in real time) the data on what is happening with each patient throughout the dialysis therapy. This system not only saves time and money for patients, who no longer have to travel to hospitals or other places where their therapy is carried out, but doctors permanently know if one of their patients stopped using the dialysis system at home, as well as the frequency of use and if it is working properly.

Read also: Great Alternatives to Perform Dialysis at Home, by Joe Cosgrove

This technology for remote patient management was created to improve the patient’s treatment in peritoneal dialysis, in addition to significantly increase the efficiency of hospital centers. This bidirectional communication platform is based on the cloud and is incorporated into the automated peritoneal dialysis system. It not only offers physicians a more accurate and timely visibility of the compliance of the therapy by their home patients, which, in turn, allows the identification and early intervention of possible complications, but it also allows collecting important data that can be later become useful information for new researchers on chronic kidney disease. After all, this system monitors patients permanently. Perhaps, the most positive thing about this technology is the possibility of accessing the patient’s compliance data in time, and thus manage possible clinical complications in advance.

The most common drawbacks that usually occur with dialysis are problems with the catheter performance, which is the hose used for fluid exchange. This is the main cause that usually spoils dialysis treatments. When this kind of issues are identified, the doctor has the possibility of making a prescription to solve what is going wrong with the dialysis on time and avoid hospitalizations or other health complications that may be derived from a poorly carried therapy. This also means saving money to the health system since patients get sick much less.

This may be a good option for those patients who live in remote areas and who find it difficult to travel frequently to health centers to carry out their dialysis therapies or to be checked by their doctors. Actually, thanks to this intelligent system, it is possible to reduce the frequency of medical check-ups to one every two months. This gives patients much more freedom and saves doctors a lot of time.

Video: Connectivity Platform Provides Telemedicine Capabilities for Remote Patient Management

Actually, it is a simple platform to manage, that even works like any smartphone app. There is a main menu which shows a list of patients and what has happened during the last week of treatment with each one of them and generates alerts in case of trouble (if a patient skipped a dialysis session, if there was a problem with the connection, or if there were complications in the process of eliminating toxins, for example.)

Internet and Big Data technology has revolutionized all aspects of human life, including health. In this case, it has meant a great advance, which, in an intelligent and practical way, can help to improve the quality of life of patients, as well as the job of millions of doctors.

* Featured Image courtesy of EdTech Stanford University School of Medicine at Flickr.com

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Early risks of peritoneal dialysis catheters

From the beginning having to go to dialysis is already a big hit to the body and to the soul. In this process, catheter is inserted into the patient to have a healthier and more comfortable life. The thing is that the patients run some risks in the early stages of this procedure.

In this post we are going to explore a bit those early risks and how they manifest in the body.

Early complications are the ones that appear in the early months after inserting the catheter. Most of the times these complications arise because there was a mistake in the catheter implantation and they get worse with all the pressure made by content in the abdominal area.

Pain

A lot of patients say that the pain that comes with the procedure is deep due to the traction of the bowels and patients can feel pain right after the catheter procedure. Another source of pain comes from the dialysate solution. Here are three exact ways that pain appears in the first stage of the catheter: having a sensibility for the PH in the solution; the compartments where the catheter is inserted; the place where the catheter goes and has contact with many organs of the body .  

Bleeding

Bleeding can come from in two ways: when arteries in the abdominal area are affected which happens when the needle is inserted to the vessels in the blood. In this case only removing the needle or the strange agent in the body will be enough to stop bleeding. The other way is venous laceration that is more of a problem to detect because there are no muscles involved. For each case a fast-medical treatment is required and specific treatments for the vessels  be done.

Perforations

Perforation risk will always be present in the catheter procedure.  The alarms should go off if bleeding, mild to high level pain or peritonitis is observed and at the same time  if fluids and liquids are pushed back through the catheter or stylet and a bad smell is sensed. These symptoms can arise immediately and medical attention is enough to manage such perforations. But there are some patients that don’t show symptoms in the early stages and the diagnosis here becomes a bit more complicated.  If this diagnosis is done late the patient runs the risk of a serious perforation, obstruction or a renal illness and internal hernia.  This diagnosis can also become tricky because the perforations could be small and remain hidden for a while and the doctors associate this with a very good catheter insertion.

Obstruction

The most common obstruction is the one that comes from the fact that the catheter is very close to the intestine and has the infusion of the solution but does not allow much space for the outflow. All these risks of obstruction have to do directly with poor orientation of the catheter’s tunnel that in turn will result in affecting the abdomen due to the memory the catheter has.  

Hernia

This risk is very painful and dangerous. It may appear when they implant the catheter and there is an intra abdominal pressure. This risk is just the consequence of not having strong abdominal muscles. There are many things that can be done to correct this in the diagnosis stage. If not, the volume of the infusion should be reduced and the patient should be controlled until a new surgery is scheduled.

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Image courtesy of Neon Tommy at Flickr.com

Hydrothorax

Hydrothorax comes from the fact that the muscles are not strong enough. This risk in not identified until later in the process. This makes it very dangerous as this will not be noticed only when fluid is present in the peritoneal cavity and there is a very high level of intraperitoneal pressure. Here women are at high risk, even more than men because all the fluid accumulates on the right side of the pleural cavity.  To identify this risk we can first see a dyspnea or an inadequate ultrafiltration but it is not immediate and it is not identified in the early stage unless there is an extra test like x-rays or a routine physical check.

Genital Edema

Edema means inflammation. One of the most seen causes for a genital edema is the peri catheter fluid extravasation into the preperitoneal space and a vaginal procedure.  

We have talked a lot about all the dialysis options that patients have. In this case, we just gave the public a series of risks that have to be taken into account when the patient is going to start his or her procedures with catheters. Sometimes the risks are not very well understood by the patients and here is where this post will help the people to more or less understanding, or to have an informed starting point, to understand what are the complications of certain procedures that involve the kidneys and that affect the rest of the body at a certain point.

Be sure to also read this post about how to make dialysis less tiresome

What is Peritoneal Dialysis, and which are the available treatments?

Peritoneal Dialysis (best-known as PD,) involves the removal of extra waste products from your blood. In this mode of dialysis, unlike other treatments, such as hemodialysis, the process is performed inside the body. This is a point that grabs the attention of many patients suffering from kidney disease, as it offers more practical conveniences. In contrast to hemodialysis, peritoneal dialysis is performed every day (just the way the kidneys work), and it is the patient who carries it out.

From the medical point of view, it is an advantage that this procedure is performed every day of the week because the blood stays cleaner and it is actually easier to prevent eventual crises. People do not have to wait to go to the hospital or to connect to the machine at home. All that is needed is a catheter which is inserted into the patient’s belly (and by a rather rapid procedure.)

Peritoneal Dialysis_Renal compensation_health

Image courtesy of PresidenciaRD at Flickr.com

In reality, there are two types of peritoneal dialysis. The best-known is continuous ambulatory peritoneal dialysis (CAPD.) In this case, the catheter is connected to a tube, and through it, a cleaning liquid is introduced to start the waste elimination process, such as salts and excess of water in the blood. The cleansing fluid enters and is installed throughout the patient’s abdomen in less than a quarter of an hour, and then the patient’s abdomen lining begins to filter the disposable substances. At the same time, it retains nutrients and other necessary elements for the proper functioning of the organism. The introduction of the liquid should be performed under conditions of total asepsis, as an infection in these circumstances would be very serious and difficult to treat. In case of poor hygiene, peritonitis may occur. Peritonitis occurs when germs enter the peritoneal cavity through the catheter. It may be treated with antibiotics, but the performance of a treatment is extremely urgent. However, if the patient follows the medical recommendations, he or she will have no problem at all.

Recommended: The impact of peritoneal dialysis-related peritonitis on mortality in peritoneal dialysis patients

The cleansing liquid (dialyzer) is left in the patient’s womb for an average of four hours so that the filtration can be effected smoothly. Obviously, each body is different, and, depending on the physiological characteristics, as well as the level of presence of noxious substances to be filtered, it remains more or less time. This treatment offers a lot of freedom since while the dialysis is taking place the patient can do everything that a normal person would do, without having to sit or lie next to a machine for hours. This is carried out in the most natural way possible: Thanks to gravity. It is not necessary to artificially suck the solution, and the patient simply replaces the liquid by the same procedure as it is mentioned above. When the dialysate has done its work, the solution containing all the residues (normally filtered by a kidney) is drained and expelled. The process is then repeated because the functions of the body do not stop, and it is repeated permanently. Hence, its name.

The other procedure is automatic. In this treatment, the patient connects the catheter to a machine, and this catches up with everything. The patient does not need to perform the exchange of new dialysate per used: It is an automatic process that even offers more freedom to patients. The machine works by cycles, like a washing machine. The patient schedules the machine at night, before going to bed, and the rest of the process is performed while the patient is resting. The interesting thing is that this machine is a totally independent equipment that works without connecting it to the drainage or the electricity. The cycling machine is not large, and, therefore, it is easy to transport, in case the patient should travel and carry it in the luggage. That is certainly another advantage.

The Merck Home Manual of Medical Information - Dialysis

Image courtesy of Amber Case at Flickr.com

It is important to keep in mind that this treatment takes more time (overnight, to be precise.) The patient lies down to sleep, and seven or eight hours later, the machine will have cleaned the whole body. Manual functions in this process are minimal, and, in some cases, simply non-existent.

No matter what your choice is for the peritoneal dialysis procedure when it comes to the number of times the dialysis process is performed per day, it is the very same thing. In both cases, it is permanent. The only difference is that in the first one is done manually, while in the second one it is carried out by a machine. In both procedures, insertion of a catheter into the patient’s belly is necessary, and, again, it is not a complicated operation.

These are very good options for patients with kidney failure and are a sign that it is possible to follow a normal life. I hope this information has been helpful to you, and I hope you share it with your friends, especially those who you know need these treatments.

Read also: The Most Common Questions Patients Have About Dialysis, by Joe Cosgrove