When kidneys fail, machine takes over

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 When kidneys fail, machine takes over
December 6, 2009 12:36 am

BY MARCIA A. CHIDESTER

FOR THE FREE LANCE-STAR

It is an hour before sunrise and Cheryl Anderson is driving down Courthouse Road in Spotsylvania County. She isn't up so early to join the morning commuter crush to Northern Virginia--Anderson is driving herself to dialysis.

Anderson, 53, makes the one-mile trip every Monday, Wednesday and Friday for a 5:45 a.m. treatment at the Fresenius Medical Care of North America dialysis center in Breezewood.

Her kidneys have failed, and dialysis, the removal of wastes and excess fluid from the blood, is critical. It is the main treatment for end-stage kidney disease, and it is Anderson's only way to stay alive unless she gets a transplant.

Each round of dialysis involves two needle sticks, both into a crescent-shaped tube known as a fistula. Anderson's fistula is embedded just under the skin of her right forearm.

The first needle stick allows blood to flow out of Anderson into the cylindrical dialyzer, or artificial kidney. The second channels the cleansed blood back into her body.

Dialysis is necessary when kidney function is less than 15 percent, said Dr. Randy Gertner, medical director of Fresenius' Spotsylvania dialysis center. Anderson has zero percent.

Anderson said she's always known she was at genetic risk for kidney failure--a few cousins on her father's side had it. She also has diabetes and hypertension, two conditions that often trigger kidney disease.

Possibility turned into reality when, in March 2004, Anderson was sick all weekend, passed out, and woke up in the emergency room.

The news was grim. Anderson's kidneys had shut down. She would be on dialysis for the rest of her life. She said she didn't know anything about dialysis and worried about whether she was going to live or die.

"I felt sorry for myself," she said.

Once Anderson started dialysis, fellow patients swapped stories with her, sharing their triumphs over nausea, lethargy and infections. Anderson learned that she wasn't alone.

"Dialysis is not a death sentence," she said. "It's just part of my life."

THE ROLE OF DIABETES

While dialysis patients are a diverse group in many ways, there are often commonalities among them, said Dr. Randy Gertner, medical director of Fresenius' Spotsylvania facility. A typical dialysis patient has had diabetes for 10 to 20 years and first comes to the attention of the dialysis center with 25 percent to 30 percent kidney function.

Dialysis patients frequently are African-Americans with high blood pressure that has been uncon- trolled for more than 10 years. African-Americans are at greater risk of hypertension, and consequently, kidney failure, than any other ethnic group, Gertner said.

About 26 million Americans suffer from chronic kidney disease, says the American Kidney Foundation. And the numbers of patients in end-stage renal failure are increasing, Gertner said. Diabetes is on the rise, and people are living longer, giving kidney disease more of a chance to set in.

Between treatments, dialysis patients must limit their fluid intake to 32 ounces a day. Ingestion of more puts a strain on the body--especially the heart, said Fresenius clinical manager Jacqueline Carrico.

Anderson's nonfunctioning kidneys produce no urine. Her bladder is, in essence, on permanent vacation. Without urinating, every drop of fluid that goes in her body must be emptied by dialysis.

Though a transplant is the only way to cure kidney failure, Anderson isn't interested in the life-saving procedure. Even though she has good health insurance, she thinks the surgery is too expensive. And supporting a transplanted kidney requires too many medications, she thinks. There is also no guarantee of success, she said.

It's best to just concentrate on living in the moment, she said.

GETTING WEAKER

Dialysis patient Charles Wormley found out that his kidneys were barely functioning when doctors did tests to get him ready for prostate cancer therapy in 2003.

It took his kidneys three more years to shut down completely. Wormley, now 61, and his wife were on a cruise when it happened.

"I woke up and I couldn't urinate," he said.

As the cruise progressed, Wormley became weaker. When the ship pulled into port, he disembarked in a wheelchair.

He started dialysis the day after he got back to Virginia.

Unlike Anderson, Wormley said he was at immediate peace with the procedure.

"I knew what it was, was told the effects and the doctor said that, after dialysis started, I would feel better," he said.

However, against the doctors predictions, feeling better took months.

Before Wormley's fistula started working, his kidneys failed completely. The only other way to administer dialysis was through a chest catheter. His energy level plummeted. He lost weight. His protein levels were hard to regulate.

Wormley, a minister, learned to monitor his diet, eating foods high in protein and low in phosphorus and potassium which build up too quickly in the blood. He avoided fried foods and wheat bread. Certain greens are a no-no. Same for most types of beans and dark sodas.

'IT IS WHAT IT IS'

Like Anderson, Wormley doesn't want a transplant. There's no guarantee that it would work or that his body wouldn't reject it, he said.

"Either God will restore my kidneys, or it's likely I'll never have kidney function," he said.

And that's OK with him.

"It is what it is," he said.

Wormley still preaches a sermon every Sunday to his congregation at Mount Zion Baptist Church on Harrison Road in Spotsylvania. He talks about his condition with folks there, hoping that his story will help others.

"We can be better by going through some things," Wormley said. "It helps us to understand people going through the same things."

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