Cleansing power: Dialysis prolongs quality of life in kidney disease

Cleansing power: Dialysis prolongs quality of life in kidney disease

By Linda Braden Albert
of The Daily Times Staff

Martha Harmon settled into her chair, put her feet up and smoothed a blanket across her legs. Donning a surgical mask, she patiently waited as Janet Lytle, R.N., prepared her for a treatment at Blount Dialysis Center under the watchful eye of Nurse Manager Polly Hall.

Harmon is one of 68 patients who takes dialysis three days each week at the clinic, located at 712 E. Harper Ave., Maryville. Harmon's kidneys failed in August 2007 following chemotherapy for multiple myeloma, a form of leukemia. The cleansing power of dialysis filters waste and excess fluid from her blood, allowing her a better quality of life.

Julia Welch, Harmon's daughter and caregiver, said, "Kidney failure was a side effect of chemo. We never imagined this would happen to Mother, but it did."

Welch complimented the staff at the clinic for the kindness and compassion they have shown to her mother and the other patients. She credited "Miss Polly" Hall -- who plans to retire next year -- with making the difficult life transition easier for both her mother and herself.

Dialysis explained

Hall opened the Blount Dialysis Center, which is privately owned by Dr. Naseen Siddiqi, in September 1999. She supervises 22 staff members, both full-time and part-time. They serve 68 patients in three shifts.

"There are three kinds of dialysis," Hall explained. "Hemodialysis, peritoneal dialysis and transplant dialysis. What we have here in this clinic is hemodialysis. ... We have a machine that has an artificial kidney. ... We'll pull the blood out, clean it up and put it back in. The process takes three hours to four hours. They get (dialysis) three times a week. That's in order to maintain good quality of life, to be able to feel good, to be able to keep the fluid off."

Kidney diseases may be a result of hypertension, diabetes or genetics, such as in polycystic kidney disease. "These are the main reasons people have kidney disease," Hall said. Accidents, chemotherapy or a major illness may also cause kidney disease.

Most people with kidney disease have been diagnosed with hypertension or diabetes and are followed by their general practitioner. Lab work is done to determine when a nephrologist, a doctor who has been educated and trained in kidney diseases, kidney transplantation and dialysis therapy, should be consulted.

"Some people are followed years before they have to go on dialysis," Hall said.

Misconceptions

A misconception is that once a person is on dialysis, treatments must continue until the end of life.

"That's not true," Hall said. "It depends on what caused it. Sometimes the kidney function will come back, but not always."

For example, a person who is extremely sick may experience kidney failure. "When you're in the hospital and you're full of infection and super-sick, your kidneys are like, 'I think I'll shut down or I'm going to be damaged.' And they shut down. We'll come in and do dialysis. When the body heals, the kidneys will come back, too."

Patients also erroneously believe that when they start dialysis, they won't live long.

"That's not true, either," Hall said. "We want a better quality of life and we want everybody to feel good. We're a treatment center here to make this happen. When people here, a lot of them, get their treatment, they go to work, they go home to do their lawn mowing, do whatever they want to do. They're not all sick. They just have to have this treatment.

"I had this one little lady, when she first came here, she said to me that a neighbor asked her, 'Have they told you how long you're going to live? My mom just lived two weeks.' That little lady was scared to death. I told her, 'I don't have a calendar, I can't tell you how long you're going to live or when you're going to die. I can't tell you that, but I can take care of your kidney function.' She's still with me. She's been on a couple of years and she's doing real good."

Patients do go through a grieving process when they begin dialysis. Hall said this is normal because in a sense, a body part has died. "There's that shock. Can you imagine? Then you have to go on dialysis. They go through (the grieving process) but once they learn that they can feel better, that they can come in here and get a treatment and be able to walk in here and walk back out and feel good -- not everybody feels real good, but a lot of them feel good when they leave. We tell them if they feel pretty good when they walk in here, we're going to make sure they feel good when they walk out."

Compassionate staff

Hall praised her patients and her staff.

"We have a great group of patients and I have a great staff to take care of them," she said. "I want (the patients) to have the best care they can possibly get." As part of this philosophy, state-of-art equipment is used. The building is also being updated and remodeled, with 18 stations to be added to the existing 12.

Compassion is a vital part of the job. "I want my staff to be kind to these people," Hall said. "People deserve that."

Blount Dialysis Center's mission is to improve each patient's quality of life.

"We make life easier for them to do whatever they want to do when they leave here," Hall said. "With renal failure, if they come for their treatments and do what the doctor tells them to do, they can have a good quality of life and be with their family and their grandchildren."

Prevention is key

To prevent or postpone the onset of kidney disease, Hall said the best thing to do is keep blood pressure and diabetes under control with diet and medication and to keep appointments with the doctor.

Dr. Mohammad Shafi, M.D., oversees patients at the dialysis clinic. He is the only full-time nephrologist in Maryville, he said.

"We do our best in terms of our treatment here at the center, but there are a lot of things patients can do at home," Shafi said. "From the dietary standpoint, they are advised to be on a restricted diet, which is a renal diet. They need to follow strictly those guidelines. These patients, because they can't make a lot of urine, have to be on fluid restrictions. These are some of the things we tell patients they have to follow strictly and religiously, or they end up in the hospital."

Shafi said early detection of kidney disease is very important.

"This center treats patients who already have established kidney disease, advanced kidney disease," he said. "But in the outpatient office setting, we try to screen out high-risk patients, which typically have diabetes or high blood pressure or any type of congenital conditions. We screen them out and try to catch the disease at its earliest stages and then, of course, do the appropriate measures to slow it down or keep it from getting worse."

Before dialysis was available, the patient had no option but to die.

"Basically (dialysis) gives them a chance to live, and not only live, but have a very decent life, actually," Shafi said. "We try to provide them a very reasonable quality of life so they can do whatever they are supposed to do on a routine basis in their daily life. This is our main goal and focus."

Originally published: August 17. 2008 3:01AM

http://www.thedailytimes.com/article/20080817/WOMEN/918753860