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EMPOWER YOURSELF !
Whether you are a newly diagnosed patient with chronic kidney disease or have a friend Q
kidneys do?
or relative undergoing kidney dialysis, this book offers help. Kidney Dialysis
100 Questions & Answers u
About Kidney Dialysis gives authoritative and practical answers to your questions about e
kidney dialysis including preparation, nutrition, complications, and tips for maintaining s
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a healthy lifestyle. Insider tips and advice are given from both physicians and actual
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“Dr. Stam’s clear and excellent compilation of information on dialysis, 100 Questions &
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Answers About Kidney Dialysis, will be extremely valuable to patients with chronic kidney
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disease and their families. It will be of great use to nurses, technicians, dietitians, and w
What is dialysis?
physicians who care for dialysis patients. With an easy-to-read format, the book delivers a
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great deal of information in a clear, concise, and interesting presentation.” r
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— John F. Sullivan, MD
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Director of Dialysis Operations Since beginning
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New York, NY u dialysis, I feel
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“I wish a book like this was available when I started hemodialysis. It answers all the questions tired all the time.
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you don’t know you need to ask. It’s simple to understand and a good reference guide.” d
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— Wendy Rivers e
Hemodialysis Patient y with time?
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watch what I eat?
What will happen
Jones and Bartlett Publishers
if I decide to
40 Tall Pine Drive
Sudbury, MA 01776
stop my dialysis by
978-443-5000
Jones
[email protected] and treatments?
Lawrence E. Stam, MD
www.jbpub.com Bartlett
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100 Questions & Answers
About Kidney Dialysis
Lawrence E. Stam, MD
New York Methodist Hospital
The Rogosin Institute
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Jones and Bartlett Publishers Jones and Bartlett Publishers Jones and Bartlett Publishers
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Copyright © 2010 by Jones and Bartlett Publishers, LLC
All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any
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The authors, editor, and publisher have made every effort to provide accurate information. However, they are
not responsible for errors, omissions, or for any outcomes related to the use of the contents of this book and
take no responsibility for the use of the products and procedures described. Treatments and side effects
described in this book may not be applicable to all people; likewise, some people may require a dose or expe-
rience a side effect that is not described herein. Drugs and medical devices are discussed that may have lim-
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Executive Publisher: Christopher Davis
Senior Editorial Assistant: Jessica Acox
Production Director: Amy Rose
Production Editors: Rachel Rossi/Laura Almozara
Manufacturing and Inventory Supervisor: Amy Bacus
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Cover Images: Top left photo: © Carme Balcells/ShutterStock, Inc.; Top right photo: © Monkey
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Library of Congress Cataloging-in-Publication Data
Stam, Lawrence E.
100 questions and answers about kidney dialysis / Lawrence E. Stam.
p. cm.
Includes bibliographical references.
ISBN-13: 978-0-7637-5417-4 (alk. paper)
ISBN-10: 0-7637-5417-X
1. Hemodialysis—Popular works. I. Title. II. Title: One hundred
questions and answers about kidney dialysis.
RC901.7.H45S67 2010
617.4'61059—dc22
2008052442
6048
Printed in the United States of America
13 12 11 10 09 10 9 8 7 6 5 4 3 2 1
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Dedication
To my wife Claudia,the great love of my life now and always.
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Contents
Preface vii
Acknowledgments ix
Part 1:The Basics 1
Questions 1–11 cover basic information regarding the kidneys and their functions,
including:
• What do the kidneys do?
• Where are the kidneys located?
• Can kidney disease be inherited?
Part 2:Dialysis 19
Questions 12–28review general notes on dialysis, such as:
• What is dialysis?
• Can children be treated with dialysis?
• What will happen if I skip a dialysis treatment?
Part 3:Preparing to Begin Dialysis 53
Questions 29–43provide an introduction to the dialysis procedure and the medical
personnel involved:
• What is a nephrologist?
• How does my doctor know I need dialysis?
• What is a shunt or access for dialysis?
Part 4:Living Well on Dialysis 89
Questions 44–56focus on continuing your lifestyle, with topics such as:
• Since beginning dialysis, I feel tired all the time. Will this improve with time?
• Can dialysis patients be sexually active?
• Can I travel as a dialysis patient?
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100 QUESTIONS & ANSWERS ABOUT KIDNEY DIALYSIS
Part 5:Nutrition on Dialysis 113
Questions 57–66offer information regarding your diet and nutritional needs while
you are on dialysis:
• Why do I have to watch what I eat?
• What is a renal diet?
• Why are potassium and phosphorus so important?
Part 6:Complications on Dialysis 137
Questions 67–77present methods of coping with day-to-day problems associated
with dialysis, such as:
• What should I do if I develop bleeding from my access?
• Why does my blood pressure fall too low during my hemodialysis treatment?
• Why do I feel weak after my hemodialysis treatments?
Part 7:Dialysis:A Healthy Lifestyle 163
Questions 78–89address ways by which you can maintain a healthy lifestyle while
receiving treatments:
• How can I lose weight as a dialysis patient?
• Can dialysis patients participate in sports?
• How will being a kidney dialysis patient affect my teeth?
Part 8:Getting OffDialysis 195
Questions 90–100provide information on ending dialysis as well as facts on kidney
transplants, including:
• Can I recover my kidney function?
• What will happen if I decide to stop my dialysis treatments?
• How can I get a kidney transplant?
Appendix 215
Glossary 219
Index 233
vi
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Preface
All of us know someone with kidney disease. Many of us have a
friend or a family member on dialysis.This is because the number of
people in the United States and the developing world with kidney
disease is growing rapidly. In 2006 in the United States, 500,000
patients received some form of end-stage renal disease therapy.The
Medicare cost to treat kidney disease was $23 billion.
Patients with kidney disease get a great deal of advice from well-
meaning friends and family members. They are encouraged to
drink more fluids to flush out the kidneys or to drink cranberry
juice.Much of this advice is wrong.
The most common reaction to learning that one has kidney disease
is fear. Patients are afraid of dying, of suffering pain and disability,
and of the unknown impact that kidney disease and dialysis will
have on their lives.
100 Questions & Answers About Kidney Dialysis is a user-friendly
guide to kidney disease and dialysis. It gives basic information
about kidney disease in language that is comprehensible to people
without a scientific or healthcare background. It will help patients
who are facing dialysis treatments learn what to expect and help
prepare them for beginning dialysis treatments.The book’s candid
treatment of difficult questions such as “How long can I live on
dialysis?” is designed to encourage patients to discuss important
and difficult issues with their doctors and families. The more
knowledge a patient has about kidney disease, the less fear he or
she will have about starting treatment.
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100 QUESTIONS & ANSWERS ABOUT KIDNEY DIALYSIS
Dialysis was one of the most significant medical achievements of
the twentieth century. Dialysis is life sustaining and improves the
quality of patients’ lives. It is important to remember that dialysis
treatments have only been available to large numbers of patients for
the past 40 years.The forces of globalization and economic devel-
opment are bringing dialysis treatments to more patients and to
areas of the world where dialysis has not been available before.The
continued improvement in dialysis machines, dialysis membranes,
new medications, and our understanding of kidney failure will
result in significant improvement in dialysis treatments during the
twenty-first century.
viii
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Acknowledgments
The process of writing 100 Questions & Answers About Kidney
Dialysis involved continuing conversations with several patients
receiving dialysis treatments at the Rogosin Brooklyn Dialysis
Unit, located at the New York Methodist Hospital in Brooklyn,
New York. These conversations were invaluable in looking at kid-
ney disease in new ways and developing creative strategies to face
dialysis treatments. I would especially like to thank Erick Lucero,
Henry Spellman, George Garcia, and Yoshi Reynolds for their
hard work on this book. Staff members at the Rogosin Brooklyn
Dialysis Unit helped provide expert information in their fields.
Robin Grande,LMSW;Lisa Modica,RD,CDN;Ellen DeMarco,
RN, MSN, MBA; Vera Auerbach; and Kotresha Neelakantappa,
MD, all worked hard to make this book possible.Thank you Rox-
anna Bologa, MD, for your guidance on peritoneal dialysis. My
wife Claudia S.Plottel,MD,gave me constant support,encourage-
ment,and technical assistance.
Description:Whether you are a newly diagnosed patient with chronic kidney disease, or have a friend or relative undergoing kidney dialysis, this book offers help. 100 Questions & Answers About Kidney Dialysis gives authoritative, practical answers to your questions about kidney dialysis, including preparation,
