Podcast
Let's Talk About Kidneys
Hosted by Dallas Nephrology Associates · EN
Nephrologists work daily to improve the quality of care for their patients. These kidney doctors know that when their patients understand their condition, they can better manage their kidney health.
"Let's Talk About Kidneys'' takes a deep dive into the Chronic Kidney Disease (CKD) patient journey. It's a podcast that inspires meaningful conversations and helps people living with CKD gain a full understanding of their disease.
With this knowledge, CKD patients can improve their outcomes while living a longer, more fulfilling life.
Do you know anyone with CKD? Tune in to gain valuable information that can help you understand and support your loved ones who are living with kidney disease.
13episodes
Episodes
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Considering Dialysis at Home
Aug 15, 202300:24:04Tap to summarizeIn this episode of the Let's Talk About Kidneys podcast, Dr. Lauren McDonald talks about the types of dialysis that can be done successfully in your own home including home hemodialysis and peritoneal dialysis. She puts extra emphasis on the fact that choosing the right dialysis modality is a very personal choice and should be made based on a patient's lifestyle and what is most important to them. Overview of Home Hemodialysis Home hemodialysis is done in the home. Currently, the dialysis machine is about the size of a nightstand and everything is self contained. It does require 3.5 to 4 hours of time each day, but you can read, watch TV, interact with family and friends, etc. Disadvantages of Dialysis at Home Privacy is one potential drawback of home dialysis. Family or friends may see the equipment or even the treatment itself if they stop by, neighbors might see delivery vans bringing supplies, etc. So for patients who prefer to keep their health and medical treatments private, home dialysis may not be the best choice. Patients must also be comfortable handling the equipment and other minor medical procedures like sticking themselves with needles. Overview of Peritoneal Dialysis One of the primary benefits of peritoneal dialysis is how portable it is. During treatment you can leave the house, go to work, go to school, run errands, etc. This also makes it very easy to travel since you just need to take masks, gloves and your exchanges. How to be Successful with Home Dialysis Dr. McDonald believes that confidence and strength are key to doing dialysis at home. It can be overwhelming in the beginning, but once you go through training and get the system down, you will get comfortable with it. The Dallas Nephrology Associates dialysis care team spends focused time ensuring each patient is trained on how to perform their dialysis treatment at home. For peritoneal dialysis, there is at least a 5 to 7 day training period one-on-one with a nurse and with home hemodialysis training will be six weeks. Plus, someone is available 24 hours a day, 7 days a week to help with questions or issues that may arise. The Role of Loved Ones There must be a family member or friend available to provide support and assistance when performing dialysis at home. They will also go through training to be sure they are prepared, plus Dallas Nephrology Associates care team helps to address caretaker burnout by orchestrating a break and bringing the patient to an in-center facility for a week occasionally. Home Dialysis Timeline From the time they make the decision, it generally takes about six weeks for a patient to be up and running with dialysis at home. This includes arranging for their access, running labs, a week or two of in-center dialysis to make sure everything goes well, training, and a home visit. Even after dialysis begins at home, the patient will still see their doctor at least once each month for labs and an examination. Your healthcare team at Dallas Nephrology Associates will be there to support you throughout the home dialysis process.
Transcribe →Types of Dialysis: What type of dialysis is best for me? Overview of the three types of dialysis.
Jul 18, 202300:19:37Tap to summarizeIn this episode of the Let's Talk About Kidneys podcast, Dr. Richey talks about the different types of dialysis and provides an overview to help patients and caregivers to understand what is involved and how to decide which modality is right for each patient. When is dialysis necessary? Dialysis is recommended when a patient's kidneys can no longer safely support them. This is determined based on several factors: Creatinine levels Potassium levels Fluid overload Dr. Richey also mentions that doctors consider how the patient feels in addition to the items above. Can they do things they could normally do in the past? What are the types of dialysis? There are three main options for dialysis: In-center hemodialysis Home hemodialysis Peritoneal dialysis (performed at home) How does dialysis work? With hemodialysis a patient's blood is run through a machine. The machine cleans the blood, removes extra fluid, and then the cleaned blood is returned back to the patient. Both in-center hemodialysis and home hemodialysis follow the same basic process. Peritoneal dialysis is very different. With peritoneal dialysis, the patient's own body is used to do the filtering. A catheter goes into the patient's abdomen and through the peritoneum. A special fluid goes into the catheter and through the peritoneum there is an exchange of toxins and fluid removal. Then you empty that fluid out from the abdomen. What are the different types of access points for dialysis? Access to the patient's blood is required for dialysis. The most common access for both in-center and home hemodialysis is an arteriovenous (AV) fistula or arteriovenous (AV) graft. Through a surgical procedure, an artery and vein are sealed together to allow for blood flow directly through the artery and into the vein. This allows for a higher rate of blood flow. For peritoneal dialysis, a special catheter is inserted into the abdomen. It sits low in the pelvis area and a small length of tubing comes from under the skin for access. What would qualify a patient to do home hemodialysis? Most patients can do home hemodialysis. However, there are a few things that make in-center dialysis a better option including: If the patient is unable to participate in the training which can take 4-6 weeks for hemodialysis. If the patient doesn't have good vision. If they don't have good family support. If they don't have the appropriate space in their home for the supplies and equipment. What is the typical hemodialysis schedule? In-center treatment will take place three days a week and, on average, patients will be at the center for four hours per treatment. Peritoneal dialysis is a seven day a week treatment. Some patients are able to do this while they sleep, but others will do it during the day. What medications are used in combination with dialysis? The most common medication used with dialysis is anti-hypertensive medications to lower blood pressure. We also use phosphorus binders to avoid long term complications with their bones and blood vessels. Other considerations can include vitamin D or medications for anemia or low blood count.
Transcribe →A Day in the Life of a Nephrologist
Jun 20, 202300:19:53Tap to summarizeNo day is ever the same for a nephrologist. Dallas Nephrology Associates' Dr. Paul Skluzacek may see his kidney patients in the office, have hospital rounds, dialysis rounds and much more. In this episode of Let's Talk About Kidneys, learn about Dr. Skluzacek's busy days providing patient care and how his schedule changes from one day to another. What is a Nephrologist? Nephrologists are kidney doctors. They have special training that includes completion of medical school followed by a residency in Internal Medicine and then additional specialty training in Nephrology. They treat systemic conditions affecting kidneys, such as diabetes, an autoimmune disease, as well as hypertension (high blood pressure) and electrolyte disturbances. Reasons to see a nephrologist may include: Protein or blood in the urine Uncontrolled high blood pressure Kidney stones Chronic kidney disease (CKD) Kidney failure Vascular access management Transplant care What does a day in the life of a Nephrologist look like? For a nephrologist, each day is different. Hours may be spent seeing kidney patients in an office-based setting at the clinic, running tests as well as interpreting them. They also prescribe medicine and treatments, conduct hospital rounds and visit their patients at dialysis centers. Nephrologists also spend time making notes on their patients' physical conditions and advise them how to stay healthy. "The clinic patients are the outpatients that we see in the office," says Dr. Skluzacek. "The focus there is to preserve their kidney function, protect their kidneys and keep them out of the hospital." Patients who are admitted to the hospital are there because their kidney illness is more serious. "They can be as sick as being on the ventilator in the ICU to patients that are there just for severe hypertension or high blood pressure control," Dr. Skluzacek says. With a schedule that includes practicing at four locations across the Dallas-Fort Worth Metroplex, Dr. Skluzacek says he spends a lot of time on the road. He also sees his dialysis patients once a week. "The vast majority of things we can handle over the phone now because we have access to the electronic health records through the Internet," he says, "but probably about half of the time, I have to go in and see a patient." The Business of Taking Care of People Dr. Skluzacek believes that compassion is an important part of being a physician, especially if you are a nephrologist. "Patients with kidney disease have complex illnesses, and it's hard to navigate the healthcare system," says Dr. Skluzacek," so we as providers need to be compassionate, not only with the patients, but with their families and their other situations."
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