Translate to Your Language

Sunday, June 22, 2014

Peritoneal Dialysis Frequently Asked Questions Part 5

This is Peritoneal Dialysis Frequently Asked Questions Part 5
Click here for Part 1
Click here for Part 2
Click here for Part 3
Click here for Part 4

15. Can I remain sexually active once I begin dialysis?
Yes. You are encouraged to maintain a normal lifestyle. Some patients may experience a decrease in sexual drive. If this becomes a problem for you, talk to your doctor. Decrease sexual drive on dialysis is multifactorial. If you are feeling sad or depressed, please make sure to talk to your doctor. Some peritoneal dialysis patients find it difficult to accept a permanent PD catheter. They worry that the catheter may affect their sexual activity and their relationship with their partner. Peritoneal dialysis nurses can help with tips on how to disguise the PD catheter.National Kidney Foundation has a very good and detailed page on sex and dialysis which you can access by clicking here.

16. Should I cancel my current Insurance?
This is a good question. Most of the patients when they start dialysis have many questions about the insurance and their coverage. Each insurance is different and have different requirement. The social worker will do everything for you. Do not worry about insurance too much. The social worker will be in touch with your insurance and try to arrange everything for you. Do not cancel any insurance policy without discussing your options with your social worker. Being on dialysis will qualify you for medicare. Discuss your options with your dialysis center social worker.

17. How will I get the supplies I need for peritoneal dialysis?
Supplies will be delivered to your home on a regular basis. A nurse will order your first shipment. A customer service representative will call you to set up future deliveries. Make sure to keep the information for you supplier so you can easily reach them. If you ever had any difficulties, call your peritoneal dialysis team. They will help you to get your peritoneal dialysis supplies. Make sure to not wait until the last day to order the new supplies. Also, if you are planning to travel, make sure to talk to your peritoneal dialysis team and supplier in advance so they can arrange the dianeal fluid to be sent to your destination. To access you Baxter account Click Here. If you need to contact Baxter Click Here. This is a video of peritoneal dialysis delivery if you would like to watch. Video

18. How often will I need peritoneal dialysis? 
Peritoneal dialysis is done every night. At night time, you or your loved one will connect you to the peritoneal dialysis machine and in the morning, you will get disconnected and can go to work. One of the benefit of the peritoneal dialysis is that because you do dialysis on daily basis, your fluid balance is well controlled and as such your blood pressure will be better controlled. Another benefit of peritoneal dialysis is that it gives the patients much autonomy and ability to continue life and have active life style. Your doctor will determine your exact peritoneal dialysis “prescription.” You can always talk to your doctor about your daily activities and see if he/she can change the prescription to be suitable to your lifestyle. If you are going to travel, make sure to arrange for the peritoneal dialysate (fluid for PD) to be delivered there in advance. You peritoneal dialysis team can help you with that. In addition, if you are going to miss a peritoneal dialysis session, make sure to contact you dialysis team and update them.

This is Peritoneal Dialysis Frequently Asked Questions Part 5
Click here for Part 1
Click here for Part 2
Click here for Part 3
Click here for Part 4



Ardavan Mashhadian D.O.
Nephrologist
1127 Wilshire Blvd Suite 510
Los Angeles CA 90017
(213) 537-0328

Friday, June 20, 2014

Peritoneal Dialysis Frequently Asked Questions Part 4


This is Peritoneal Dialysis Frequently Asked Questions Part 4
Click here for Part 1
Click here for Part 2
Click here for Part 3
Click here for Part 4

11. How long does a peritoneal dialysis treatment take?
Peritoneal dialysis is done every day at night time. The average time is about 8-10 hours, depending on what your doctor prescribes. Some patients may need to have an additional exchange during the day. Since peritoneal dialysis is done every day, patients' blood pressure is much better. In addition, because peritoneal dialysis is done at home, it can be very time saving for patients. If you are going to travel or miss your dialysis, make sure to call your peritoneal dialysis team and let me know.

12. How long will it take me (or a family member/caregiver) to learn to do the treatment?
This is a very good question. The reality is some people may need more time. The important thing is to not rush. In addition, always call your dialysis team if any questions comes up. Remember, asking question is a good sign. It means you care about doing your treatment in best way. And this will make your dialysis team happy. Do not get frustrated. Frustration will not help you. Establish a good relationship with your peritoneal dialysis team especially the nurses. Make sure you have their 24 hours number handy.

13. What happens to my job? Can I continue to work? 
The answer to this question depends to your overall wellbeing. In my experience, peritoneal dialysis patients remain more independent compared to hemodialysis patients. Peritoneal dialysis is done mostly at night time. In addition, your doctor can change the prescription so it can fit your schedule better. Many peritoneal dialysis patients continue to work. Sometimes, hours or duties may need to be changes. Continuing to work helps dialysis patients to retain a better quality of life and have higher self satisfaction. Do not take guilt feeling or be shy at work because your kidneys have failed. This was not your fault. Also, ask around at work and see if any of co-workers is interested to participate in a blessing act of kidney donation. Remember, it does not hurt to ask!

14. Will I qualify for disability?
Once you start peritoneal dialysis, your doctor and peritoneal dialysis team will see you on monthly basis. They will evaluate your health and type of work environment to determine if you can continue your job. If you are unable to work, your social worker will help you determine what benefits you are entitled to and how to apply. Do not fall in the trap of taking a sick patient role. Continuing your job and profession can have many positive psychological benefits in addition to financial benefits. One of the distinguishing factors in peritoneal dialysis is that you can continue to work. Now I understand some times, this will not be possible. Talk to your dialysis team. They will try to help you through this. If your dialysis team and you decided not to continue work, the social worker will assist you with different benefit plan. This is noting to be ashamed off. Dialysis team and social worker will assist you to improve your financial shortcomings.

This is Peritoneal Dialysis Frequently Asked Questions Part 4
Click here for Part 1
Click here for Part 2
Click here for Part 3
Click here for Part 4



Ardavan Mashhadian D.O.
Nephrologist
1127 Wilshire Blvd Suite 510
Los Angeles CA 90017
(213) 537-0328

Monday, June 16, 2014

Peritoneal Dialysis Frequently Asked Questions Part 3


This is Peritoneal Dialysis Frequently Asked Questions Part 3
Click here for Part 1
Click here for Part 2
Click here for Part 3
Click here for Part 4

8. How will dialysis affect my family?
Family and social support is very very important in dialysis patients. As you start peritoneal dialysis, some of the roles in family will change. With peritoneal dialysis, you will be able to remain much more independent than hemodialysis. Remember, you will need your family for support as you begin dialysis, and your family will need your support as well. It is hard to see a loved one starting dialysis. Some patients start becoming frustrated on dialysis and may start blaming themselves or their family members. Try to stay positive. Family members are very important. I can not stress enough on this. Make sure to take your family members to the dialysis unit too. This way, they will see some of the challenges you are facing. In addition, try to make a close friendship with your family members and dialysis team. When you get referral to a transplant center, one of the main things they look at is who is your family members and how much social support you have to help you through transplant. Also remember, family members could be best possible source of kidney donation.

9. Will I still take the same medications once I start dialysis?
This is a good question. I know as a patient with kidney disease, you may have many medications to take. Your nephrologist (kidney doctor) will decide what medications are needed once you begin dialysis. No new medications (over-the-counter or prescriptions from other doctors) should be taken without checking with your nephrologist. If any doctor starts you on new medications, let them know that you are on peritoneal dialysis. Different medications need different dose adjustment once a patient native kidneys fail and start peritoneal dialysis. Always always always have an updated list of your medications and their dosages you are taking and show it to your dialysis team. If the dialysis team wants to change or add new medication write down their name and indications. Remember, try to stay active. It is easy to lose hope and be passive. If you want to get better, you need to stay positive and take role. Be involved.

10. Will I qualify for Medicare to help pay for the peritoneal dialysis?
Yes. In United States all dialysis patients qualify for medicare. Your dialysis unit social worker will assist you with Medicare and other sources that might be available to help pay for dialysis. Each peritoneal dialysis center should have at least one social worker. Try to know the social worker closely. These people can make your life much easier. Talk to them. Let them know about what you do. Tell them your financial and social needs. The dialysis social workers have resources to help you in many ways. Before your monthly peritoneal dialysis check up, take a piece of paper and write down your questions and difficulties you face on peritoneal dialysis. The dialysis team and social worker will try to help you with them.

This is Peritoneal Dialysis Frequently Asked Questions Part 3
Click here for Part 1
Click here for Part 2
Click here for Part 3
Click here for Part 4



Ardavan Mashhadian D.O.
Nephrologist
1127 Wilshire Blvd Suite 510
Los Angeles CA 90017
(213) 537-0328

Sunday, June 15, 2014

Peritoneal Dialysis Frequently Asked Questions Part 2

This is Peritoneal Dialysis Frequently Asked Questions Part 2
Click here for Part 1
Click here for Part 2
Click here for Part 3
Click here for Part 4

4. Is Peritoneal Dialysis a painful therapy?
Contrary to hemodialysis, there is no needle involved in peritoneal dialysis. As such it should not be painful. Occasionally, after the dialysis catheter is inserted, abdominal discomfort may occur for one week. If discomfort continues, adjustments can usually be made to your dialysis exchange. Always report pain or discomfort to your doctor or nurse. Pain at the exit site or around it can mean skin infection or even more importantly peritonitis. If you start having pain or abdominal discomfort, you should notify your peritoneal dialysis team. They will obtain culture of abdominal fluid and try to treat you accordingly.

5. Will my kidneys ever work again?
The answer to the question depends to what was the underlying reason for kidney loss. Some patients have had chronic kidney disease for many years, and now, their disease has progressed to end stage renal disease. On the other hand, some patients has had acute kidney injury and may recover some kidney function. Some of the patients on dialysis still make urine. This does not mean that they can come off of dialysis. One of the most important issues is to prevent further deterioration in kidney function. This requires close follow up with dialysis team and avoid any medications that can cause kidney damage such as contrasted imaging.

6. I still make urine, so why do I need to start dialysis now?
Kidney's job is to control your body's fluid status, correct your electrolytes, and get rid of toxins. Making urine is only part of what kidneys do. Dialysis will help you to get rid of extra fluid, balance your electrolytes and more importantly get rid of toxins. Many patients, at first, are hesitant to start dialysis. They associate dialysis with death and pain. However, many of these patients start feeling much better after few sessions of dialysis. This is because dialysis helps to remove many toxins from their body that had been gradually accumulate with decrease in kidney function. In addition, once patients start on dialysis, they start feeling bette, more energetic, and can continue their normal activities. Make sure you ask your dialysis team to refer you to transplant center as soon as possible to be evaluated for kidney transplant. Also make sure to ask around from friends, family members, and church people to see if they like to be a donor.

7. What will happen if I miss a dialysis treatment?
This depends to the patient's residual renal function and whether the patient does hemodialysis or peritoneal dialysis.  Missed treatments allow waste products and extra fluid to build up in your body, which often leads to health problems. Peritoneal dialysis patients are on dialysis seven days of the week. As such peritoneal dialysis patients fluid status is much better that hemodialysis patients. Also toxins are removed in continuos manner vs hemodialysis patient that receive dialysis 3 times per week. If you are going to miss a dialysis session you need to inform you dialysis team.

This is Peritoneal Dialysis Frequently Asked Questions Part 2
Click here for Part 1
Click here for Part 2
Click here for Part 3
Click here for Part 4



Ardavan Mashhadian D.O.
Nephrologist
1127 Wilshire Blvd Suite 510
Los Angeles CA 90017
(213) 537-0328

Friday, June 13, 2014

Peritoneal Dialysis Frequently Asked Questions Part 1

This is Peritoneal Dialysis Frequently Asked Questions Part 1
Click here for Part 1
Click here for Part 2
Click here for Part 3
Click here for Part 4

When I see patients in PD clinic, I encounter similar questions. This page should answer many commonly asked questions regarding peritoneal dialysis in different languages. If you have any other questions, please write it on this blog post, and I will try to answer them to the best of my ability.

1. How often will I have to come in for check ups?
Most dialysis centers would like to see their patients at least once a month unless your doctor or nurse instruct you otherwise. If you are not sure, call you PD nurse. There should be a 24 hour nurse available to answer questions. Remember, on each visit, the doctor will go over you lab results and try to optimize your dialysis. Studies show, patients who have good followup with their dialysis team, have good compliance and better outcomes.

2. Do I need a special place to do my dialysis?
One of the most important issues with PD is the setup. Another words, if you dedicate a special place for PD machine and have all the materials ready in one place, it should make it easier for you to connect yourself to the PD machine. Hand hygiene is very important. In addition, the room that you choose to do your dialysis in should be clean and free of clutter, have good lighting and have enough room for all the dialysis supplies.

3. How long will I need to undergo this therapy?
This is a very good question. If you are asking this question, it means you want to get better as soon as possible. With advanced kidney disease, dialysis or kidney transplant is a lifelong therapy. That being said, keep in mind that with other organ failures, such as heart failure and liver failure, there is no such therapy like dialysis to keep patient alive and functioning. In addition, if you have good follow up with your dialysis team and otherwise in good health, you should be referred to a transplant center as soon as possible. Remember, ask around from family members, relatives, friends, and church members to see if they are willing to donate their kidneys. Do NOT be shy. Do NOT be ashamed. Being on dialysis is not your fault. A lot of people would love to be part of such a good act and make a difference.

This is Peritoneal Dialysis Frequently Asked Questions Part 1
Click here for Part 1
Click here for Part 2
Click here for Part 3
Click here for Part 4



Ardavan Mashhadian D.O.
Nephrologist
1127 Wilshire Blvd Suite 510
Los Angeles CA 90017
(213) 537-0328

Thursday, June 12, 2014

How to do Peritoneal Dialysis?

http://www.pinterest.com/amashhadian/peritoneal-dialysis/
There are 2 ways to do dialysis. 1. Hemodialysis and 2. Peritoneal dialysis. When I discuss starting dialysis on my patients, I will talk to them about both.

However, personally I like peritoneal dialysis more because patient has much mo autonomy. In addition, with peritoneal dialysis, you can control extra fluid more easily, and this may reduce stress on the heart and blood vessels. With peritoneal dialysis you are able to eat more and use fewer medications. You can do more of your daily activities and it is easier to work or travel.

However, unfortunately, there are some people for whom peritoneal dialysis may not be appropriate. The abdomen or belly of some people, particularly those who are morbidly obese or those with multiple prior abdominal surgeries, may make peritoneal dialysis treatments difficult or impossible. Peritonitis (infection of abdomen) is an occasional complication although should be infrequent with appropriate precautions. When making a decision about the type of treatment, you should take into consideration that peritoneal dialysis is usually a daily process, similar to the working of the kidney and may be more gentle with fluid removal from the body.

Peritoneal dialysis is an effective form of dialysis, has been proven to be as good as hemodialysis.Peritoneal dialysis is not for everyone. People must receive training and be able to perform correctly each of the steps of the treatment. A trained helper may also be used.


Ardavan Mashhadian D.O.
Nephrologist
1127 Wilshire Blvd Suite 510
Los Angeles CA 90017
(213) 537-0328