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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Acid-Base Compensation: What is it, and how to prevent it?

Acid-base Compensation is the relative constancy of the acid-base relationship of the internal environment of a living organism, particularly when it comes to the renal system. Also called acid-base balance, acid-base balance, equilibrium of acids and bases. It is an integral part of homeostasis. Quantitatively it is characterized either by the concentration of hydrogen ions in moles per one liter or by the hydrogen pH. The tissues of a living organism are very sensitive to fluctuations in the pH value – outside the permissible range, protein denaturation occurs: cells are destroyed, enzymes lose their ability to perform their functions, and the body can die. Therefore, the acid-base balance in the body is tightly regulated. There are several buffer systems that reversibly bind hydrogen ions and prevent any changes in pH. The bicarbonate buffer system (the most powerful and most controllable among buffer systems) is particularly important: an excess of protons interacts with bicarbonate ions (metabolic alkalosis) to form carbonic acid. Further decrease in the amount of carbonic acid occurs as a result of an accelerated release of carbon dioxide as a result of hyperventilation of the lungs (concentration is determined by the pressure in the alveolar gas mixture.)

There are several approaches for the evaluation and classification of acid-base balance alterations. The physicochemical proposal is the most recent and is based on the difference of strong ions, the total concentration of weak plasma acids and the partial pressure of arterial carbon dioxide. Of great acceptance among anesthesiologists and intensivists, it is a tremendous complex approach, both technical and interpretation. Therefore, in this post, the physiological approach will be used, based on pH, and plasma bicarbonate, which is the simplest, most rigorous and practical way to systematically classify and treat alterations in the acid-base balance.

First of all acid-base disorder must answer three basic questions. The first has to do with what disorder it is. The second, if the secondary response is adequate. The third, about the cause of the disorder. Metabolic acidosis is divided according to the value of the anionic hiatus. Acidosis with increased anionic hiatus: acid gain, endogenous or exogenous, predominates. They are normochloremic acidosis. Acidosis with normal anionic hiatus: the loss of bicarbonate outside the body predominates. They are called hyperchloremic acidosis.

Approximately three-quarters of the value of the anion hiatus correspond to serum albumin, which is an anion, so in the assessment of the anion, hiatus should be taken into account if hypoalbuminemia, as well as other circumstances.

The acid-base balance of the organism is possible thanks to the interrelation of three systems: intracellular and extracellular tampons, which cushion in a minute the acute changes of acid-base balance; respiratory compensation, which starts in minutes and is completed in hours, and renal excretion of excess acids, which takes more time. The total buffer capacity of the organism is about one thousand mMol (forty percent in the extracellular space, and sixty in the intracellular space.)

To plan an adequate treatment, and as in any acid-base disorder, it is essential to identify secondary responses (compensation mechanisms), whether these are adequate or not, and whether there are other acid-base mixed disorders or associated electrolyte disorders.

Read also: How to reduce the chances of suffering renal failure, by Joe Cosgrove

In metabolic acidosis, the key aspect of treatment lies in blocking the source of acid production (eg, by providing insulin in diabetic ketoacidosis,) always taking into account the compensations that exist, the rate of acid production and its cause (lactic acidosis due to hypoxia or alcohol intoxication are more serious due to its rapid evolution.) Special caution when planning treatment deserves the detection of hypokalemia since it implies a serious potassium deficit. The replacement of bicarbonate should be very cautious, applied only in certain circumstances (eg, extreme hyperkalemia, potentially fatal drops in pH,) and always assessing the risks and benefits. The only objective is to gain time until the homeostatic mechanisms manage to increase the pH.

To the problem of acidosis due to keto acids caused by insulin deficiency, water deficit, circulating volume deficit, the coexistence of lactic acidosis and potassium deficit, which in turn depends on the duration and magnitude of polyuria secondary to poor glycemic control, and the degree of replacement of losses.

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The general treatment plan should include, therefore: Insulin, re-expansion of the extracellular volume, correction of possible potassium deficit, and the decision to administer or not bicarbonate should be valued with great caution. The alterations in the bicarbonate concentration or the partial pressure of carbon dioxide in the arterial blood are accompanied by a compensatory response in the other element. If the compensation is adequate or it will not allow detecting if there is a second or third associated disorder, in what constitute the mixed disorders that are very frequent in clinical practice and that implies a greater severity.

In order to detect mixed disorders, it must be taken into account that a compensation will never be able to normalize the pH. Its treatment and the priority of the actions to follow will depend on the cause and predominant acid-base disorder, always taking into account the associated electrolyte alterations.

Recommended: Acid-Base Disorders

* Featured Image courtesy of Pixabay at Pexels.com

How to reduce the chances of suffering renal failure

There is a worrying statistic in America: one in almost three Americans is on the verge of suffering any type of kidney disease due to diabetes, hereditary aspects, high blood pressure or kidney failure. Joe Cosgrove has previously pointed out several aspects on how to effectively reduce the chances of suffering any type of renal disease and how to cope with the dreary effects of both dialysis and other treatments for renal failure; however, here is a word of advice for those individuals who want to increase the chances of getting the most out of their kidneys while keeping them healthy.

First of all, and despite it being quite obvious, the vast majority of individuals are born with two kidneys. What people do not know, however, is that they can live just using one. On a daily basis, the kidneys can filter up to 200 liters of blood: in this process, they can also remove up to 2 liters of waste, water, and toxins. In fact, water and waste products often leave the body in the form of urine, thusly allowing the kidneys to regulate the body’s fluids and its levels. Kidneys are also responsible for producing and releasing hormones that are key in regulating blood pressure, producing more red blood cells and maintaining solid and healthy bones.

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Since the human body tends to wear off over time, the kidneys are not the exception. The kidneys stop working as they should slowly over the course of time, which is why most people often realize they suffer from any sort of kidney disease until it is too late. It is difficult to prevent it, since detecting it during early stages is no easy task. Thus, protecting the kidneys is something every individual should aim to irrespective of whether they have hereditary conditions or not:

Get Checked

Everyone is open to suffering from any type of kidney disease regardless of whether they keep a healthy lifestyle, or have hereditary conditions, or not. People who believe they are at risk for any type of kidney disease should not overlook the importance of getting their kidneys checked by their primary physician or a nephrologist. Since the kidneys do not show early symptoms of damage, most people tend to adopt a relaxed stance when it comes to taking the time to scheduling an appointment with their physicians. That is why prevention and checking often walk alongside each other.

Nonetheless, it is quite easy to check the kidneys. The first test is a urine test that aims to find the presence of albumin (a protein) in the fluid. Whenever an individual has got protein in their urine it is quite possible to assert that that individual is showing early symptoms of kidney failure. When there is just too much protein in the fluid, it means that the kidneys are failing and are starting to leak albumin or protein in this case. The second test aims to find creatinine in the blood flow. Creatine is one out of many different types of waste products that can be found in the body. It comes from muscle metabolism, and healthy kidneys remove it. This test is also used to determine an individual’s glomerular filtration rate, which is a statistic that is commonly used to reflect how well the kidneys filter waste products from the blood flow.

Control sugar levels

And control blood pressure as well. High blood pressure and diabetes are known for being two major causes of all sorts of kidney disease. Since the kidney is somewhat of a vascular organ—as it contains a myriad of different blood vessels—, diseases that affect these vessels such as diabetes and high blood pressure can ultimately inflict damage to the organs. In fact, even a minor degree of high blood pressure and diabetes can result in terrible kidney damage. As mentioned above, individuals, regardless of their current condition, should control both aspects in order to avoid falling victim of early kidney disease.

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Control weight

Keeping a healthy lifestyle is as important as the two aforementioned aspects. Weight plays a vital role in overall kidney health. Overweight, for instance, forces the body to work much harder in order for it to successfully filter all the waste products and meet metabolic needs. Besides, obesity and having excess weight can lead to the development of diabetes and pressure-related complications. Thus, it is quite important for individuals to maintain a healthy diet and a healthy lifestyle, working out from time to time and paying special attention to their weight. Weight loss and exercise is key when it comes to reducing the risk of developing both conditions. In fact, smoking also helps increase the chances of suffering any type of renal disease and high blood pressure, and it also worsens any condition. Quitting smoking, therefore, is crucial.

* Featured Image courtesy of Pixabay at Pexels.com