Finding out you have Chronic Kidney Disease (CKD) can be scary. A patient may feel overwhelmed knowing that they are losing their kidney functioning. Gaining knowledge about CKD and what options are available will help patients feel a little bit more in control of their life and what to expect.
Symptoms of kidney failure are: swelling of ankles, hands and face; feeling tired; trouble sleeping; loss of appetite; nausea and vomiting; and itching. Patients may ignore these symptoms because they may attribute them to other conditions.
If a patient gets diagnosed with Chronic Kidney Disease, they should know that they are not alone and there are options to help live life even with kidney failure. Statistics show that:
- One in seven Americans has Chronic Kidney Disease, according to the National Institutes of Health;
- Almost half a million are on dialysis;
- And another 193,000 live with a functioning transplanted kidney.
With Kidney Action Day coming up on April 29, it seems a great time to take a look at kidney disease, your risks and treatment options.
High blood pressure and diabetes are the two major causes of kidney disease, with almost half of patients having one or the other underlying condition. Other causes range from complications from other health issues, to genetic conditions to injuries.
Chronic Kidney Disease effects African-Americans at a rate 3.5 times the general population. Hispanics have Chronic Kidney Disease at 1.5 times the rate of non-Hispanics.
The rate of Chronic Kidney Disease rose sharply in the 1980s and 1990s before peaking in 2006. Numbers have declined slightly since.
Still, Medicare spending for patients with chronic kidney disease — ages 65 and older — exceeded $50 billion in 2013 and represented 20 percent of all Medicare spending in this age group.
Clearly, Chronic Kidney Disease is a major health concern.
The kidneys are two bean-shaped organs, each about the size of a fist. They help keep the body chemistry in balance at all times. Kidneys make urine to get rid of wastes and extra water, helps control blood pressures, helps build red blood cells, and balances minerals. A diagnosis of Chronic Kidney Disease means the kidneys are damaged and can’t filter blood the way they should.
For those who know they will need dialysis, patient education is the key to choosing the right course of care. Patients are encouraged to receive their Dialysis Options Education while in Stage 3 or 4; this is to avoid an unnecessary emergency start of dialysis treatments. More knowledge about dialysis allows patients to be able to make informed decisions about how they want to live their life with kidney disease.
Doctors use blood and urine tests to measure kidney function. The progression of Chronic Kidney Disease is measured in five stages. Stage 1 means the kidney is working at 90 percent or more of capacity — this is normal but there may be something amiss with the structure. As kidney function decreases, patients move through stages 2 and 3. .
By the time the disease has reached stage 4, physical symptoms become more apparent and medical intervention may be necessary. In stage 5, the patient can no longer survive without dialysis – a process that slowly removes wastes and extra fluid to help keep a person’s body chemistry in balance.
Hemodialysis-the process of removing, filtering, and returning blood to the body- can be performed in a clinic setting where patients receive treatment three times a week between 3-4 hours each session. Hemodialysis can also be done at home on a more convenient schedule. For some patients, that may include having the blood filtered overnight while the patient sleeps. There is also another home therapy option called Peritoneal Dialysis, which filters using the body’s natural membrane. A tube, placed in the patient’s belly, removes waste and extra fluid.
Kidney transplant may also be an option for those who meet the Kidney Transplant Centers’ waitlist criteria. In the Bay Area, the average time a patient will be on the waitlist is between 5-9 years, unless they have a living donor.
Many patients may be concerned of the cost of dialysis treatments. Patients diagnosed with End Stage Renal Disease and who have earned enough work credit, regardless of age, can be eligible for Medicare. This will help pay for 80 percent of the costs. A supplemental insurance is advised to pay for the remaining 20 percent. The clinic social workers can assist patients by directing them to resources to help with insurance issues.
The individual decision depends on the patient’s medical needs, what kind of lifestyle the patient wants, and the advice of the nephrologist.
Here in the South Bay, we’re home to Satellite Healthcare, a major dialysis organization that offers services for patients seeking treatments in-center or at home. Satellite Healthcare is the leader among providers of home therapies.
Naturally, we’re a little biased. We think Satellite’s non-profit approach that puts patients first is the way to go. The company is also a leader in nephrology research and hosts a series of events in which doctors and patients can influence the direction of care. Patient satisfaction and quality of care statistics suggest Satellite is on the right path.
Of course, avoiding kidney disease is the best course.
Diet is important at every stage. Look to lower salt intake. Managing protein intake – both the quantity and type – should be done in consultation with a registered dietician. Generally, a heart healthy diet that’s rich in fish, lean meats, fruits and vegetables is preferable. Limiting phosphorous and potassium may also be important.
If you or someone you love does develop Chronic Kidney Disease, become an active participant in making all care decisions. One size does not fit all. Choices for the type of dialysis treatments need to be made with the patient’s well-being in mind. We at Satellite Healthcare are here to help at every step of the journey.
Juliet Famadico holds a master of social work degree and is a PATHfinder with Satellite Healthcare in San Jose. Reach her at famadicoj@SatelliteHealth.com.