Kidney disease means a changed life with 'constant peripheral problems'

Kidney disease means a changed life with 'constant peripheral problems,' demands 'strong will to survive'

By STEVE EIGHINGER
Herald-Whig Staff Writer

If asked, Reggie Coleman will try to be as truthful as possible about what it is like to live with kidney failure.
Depression, anxiety and frustration can be commonplace.
"Those are constant peripheral problems," said Coleman, who undergoes dialysis six days a week. "You have to have a strong will to survive."
Coleman has been a familiar public figure in Quincy for most of the past 30 years, beginning as a radio personality in the early 1980s and later as an advocate for higher education and civil rights.
But his world has been turned upside down in the past decade through a combination of health problems, punctuated by kidney disease, which led to kidney failure.
"Your body just does stuff you don't even think about," Coleman said.
At least until parts of that body, which Coleman terms "a tremendous engineering miracle," stop functioning.
Coleman is part of what has been labeled the "quiet epidemic" -- kidney disease. March is National Kidney Disease Awareness Month, and much focus is being made on highlighting facts about the disease:
º 26 million Americans now suffer from kidney disease, according to the National Kidney Foundation.
º Kidney failure has grown to the ninth-leading U.S. cause of death.
º 18 people die each day awaiting a kidney transplant. Of the more than 110,000 Americans awaiting an organ transplant, 87,000 of those are awaiting kidneys.
Kidney disease normally does not discriminate by age, gender or race, but there are some demographic groups that have proven more susceptible than others.
Those who suffer from high blood pressure, diabetes or are overweight could be prime candidates.
Dr. Roula Tanios, a nephrologist with Blessing Physician Services, said young people normally are not as much at risk for kidney disease as older adults. Tanios said the elderly, African-Americans and Hispanics have proven to be high at-risk populations, but there is no ironclad pattern. Genetics also might play a role, she said.
The bottom line?
"Everyone needs to be screened," Tanios said.
Balancing the body
Coleman, an African-American, no longer sleeps in a bed, preferring a recliner so his almost-nightly dialysis can be done while he sleeps.
"Kidney failure is a part-time job," Coleman said. "I know more about kidneys than I ever wanted to. When kidneys don't work, you'll die of internal poisons.
"Dialysis can do part -- but not all -- of what kidneys do. The human body is a tremendous engineering miracle, and when one organ starts to fail, it affects other parts of the body."
Dialysis is a treatment that performs some of the duties done by healthy kidneys. It is needed when a person's own kidneys can no longer take care of the body's needs.
Dialysis is mandated when a person reaches end-stage kidney failure, which is usually by the time kidneys lose about 85 to 90 percent of their function.
Like healthy kidneys, dialysis keeps a person's body in balance. Dialysis does three things:
º Removes waste, salt and extra water to prevent them from building up in the body.
º Keeps a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate.
º Helps to control blood pressure.
Kidney failure is not necessarily always permanent. In some kinds of acute kidney failure, a patient will get better after treatment. In others, dialysis might be needed for only a short time until the kidneys get better.
In chronic or end-stage kidney failure, the kidneys do not get better and dialysis is needed for the rest of the person's life. If a patient's doctor says he is a candidate for a transplant, he can choose to be placed on a waiting list for a new kidney. That wait is normally three to five years.
The dialysis process
Dialysis can be done in a hospital, in a dialysis unit that is not part of a hospital, or at home. A patient and physician decide which place is best, based on medical condition and personal wishes.
Dialysis machines work by using diffusion and ultrafiltration. A very fine material, called a membrane, allows blood and fluid to flow through it. In the machine, the blood flows in one direction, and on the other side of the membrane, a special fluid, dialysate, flows in the opposite direction.
Dialysate is a fluid that has different chemicals in it, such as potassium and calcium. A doctor decides what mixture of chemicals is needed for each patient. The dialysate has bicarbonate in it to lower the higher acid levels that these patients often have. The blood and dialysate mix together. The waste products are removed from the blood and caught up in the fine membrane.
Unlike Coleman, Sandra Porter of Quincy makes three trips a week to the DaVita Kidney Dialysis Care Facility at Blessing Hospital for her treatments.
"It's something I have to do," said Porter, 73, who lives by herself in one of the cottages at Good Samaritan Home.
Like many with kidney disease, Porter said she never had any kidney-related problems before a doctor's diagnosis a few years ago that she was headed for trouble.
"You think it's the end," she said. "It's a shock."
Porter is now comfortable with and accepts her multiple trips to the DaVita facility as part of her life regimen. She is determined to remain in control of her life as much as possible.
"In between sessions, I find myself beginning to feel run-down ... exhausted," she said. "I make myself go to high school and college basketball games. You have to make yourself do it sometimes, because you are better off."
DaVita -- which is Italian for "giving life" -- is a leading provider of kidney care in the United States, delivering dialysis services and education to patients with chronic kidney failure and end-stage renal disease. DaVita has 26 facilities spread across Illinois and more than 1,600 nationwide. One of every four people receiving dialysis treatment receives it through a DaVita location.
Lifestyle changes
Porter said not only her lifestyle, but also her diet underwent some drastic changes.
"I had to give up a lot of the good stuff," she said. "You work with a dietitian, and you get used to what you can and can't eat, and what you can and can't do."
Coleman says adjustments to what was once "normal" are necessary.
"For some people, that is difficult," he said. "I can no longer work or lift anything weighing more than 50 pounds. When you (were) a workaholic, it drives you nuts. I used to be busy twelve to 14 hours a day. I had always been an active person."
Kidney patients need to drastically reduce their liquid intake, usually to no more than one liter -- or about four glasses Âa day.
"And there is fluid in everything," Coleman said.
Reducing the intake of potassium, phosphorus and numerous other elements also must be highly moderated.
Patients on dialysis can lead relatively normal lifestyles, within reason. Sometimes, depending on their dialysis schedule and where they are going, they can make arrangements for treatment the way Porter does. She has family members who live In Lincoln, Neb., and can visit them with no problem.
"I just call the DaViota (facility) up there and make plans to receive treatment up there," she said.

-- seighinger@whig.com/221-3377

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