Henry Feeser's Peritoneal Dialysis (PD) journey

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Insights Into Peritoneal Dialysis Fluids & Math

November 6, 2023 / / 0 Comments

The percent dextrose in the solution used for peritoneal dialysis plays a crucial role in the process. Peritoneal dialysis is a form of renal replacement therapy that involves using the peritoneal membrane in the abdomen as a natural filter to remove waste products and excess fluids from the body.

The dextrose solution used in peritoneal dialysis serves two main purposes:

Osmotic gradient: The dextrose in the solution creates an osmotic gradient across the peritoneal membrane. When the solution is infused into the peritoneal cavity, the dextrose molecules draw water from the bloodstream into the peritoneal space through osmosis. This movement of water helps remove waste products and excess fluids from the body.

Ultrafiltration: The concentration of dextrose in the solution determines the extent of fluid removal during peritoneal dialysis. Higher concentrations of dextrose, such as 2.5% or 4.25%, create a stronger osmotic gradient and promote greater fluid removal. This is known as ultrafiltration. The dextrose molecules draw more water from the bloodstream into the peritoneal cavity, resulting in higher volumes of fluid being removed during the dwell phase of peritoneal dialysis.

Closer to home, I use on alternative nights a back-and-forth combination of first a 5-liter bag of 1.5% solution accompanied by a 3-liter bag of 2.5% solution. The next night the solutions are reversed with a 3-liter bag of 1.5% solution and a 5-liter bag of 2.5% solution. Why so? I have found through experience and experimentation that this mix results in the least amount of leg cramps during the night. It does not preclude them. Often I must get up out of bed and walk around to get things back to normal, but that goes with the treatment.

I know you all enjoyed your high school algebra classes where you were required to solve word problems, thinking you would never encounter them in real life. But real life is real life and it is full of word problems like the following in this context: What is the overall percentage of dextrose in the two different mixtures I am using for dialysis as outlined above?

To determine the percent dextrose solution of the combined solutions, you need to calculate the total amount of dextrose in both solutions and divide it by the total volume of the combined solutions.

Let’s calculate the total amount of dextrose in each solution first:

5 liters of a 2.5% dextrose solution:
Total dextrose = 5 liters × 2.5% = 0.125 liters or 125 milliliters (ml)

3 liters of a 1.5% dextrose solution:
Total dextrose = 3 liters × 1.5% = 0.045 liters or 45 milliliters (ml)

Now, add the total amounts of dextrose from both solutions:

Total dextrose = 125 ml + 45 ml = 170 milliliters (ml)

Next, calculate the total volume of the combined solutions:

Total volume = 5 liters + 3 liters = 8 liters or 8000 milliliters (ml)

Finally, determine the percent dextrose of the combined solutions by dividing the total amount of dextrose by the total volume and multiplying by 100:

Percent dextrose = (Total dextrose / Total volume) × 100
= (170 ml / 8000 ml) × 100
≈ 2.125%

Therefore, the percent dextrose solution of the combined solutions is approximately 2.125%. Following the same methodology for the alternative days yields a solution of approximately 1.72%.

And now we know what combined percentages are, how to calculate them for your own prescription, and in general what the fluids are doing in your peritoneal lining. QED

Understanding Velphoro (Sucroferric Oxyhydroxide) in Peritoneal Dialysis: A Comprehensive Guide

November 3, 2023 / / 0 Comments

As you can ascertain from the lab graphic above, my phosphorus levels have been banging up against the upper limit for some time. The actual readings from left to right above are 5.5, 4.8, 5.7, 5.3, 5.4 and 5.4. When they hit 5.7, my nephrologist put me on a phosphorus binder named Velphoro. It is a large, almost one-inch across-brown tablet that I chew before breakfast that has a chalk-like consistency. I am also directed to chew one of the tabs if I have a heavy protein-laden meal like a steak, fish, or chicken.

Since I am ingesting this “stuff,” it would behoove all of us currently on or contemplating dialysis to know more about Velphoro, a 500 mg tab made in Switzerland and distributed by Fresenius North America, Waltham, MA 02451. With this thought in mind, I fired up my AI Assistant Poe, inputted the prompt in the graphic below, and obtained results that follow the graphic prompt.

Assistant Poe Assistant

Introduction:
Peritoneal dialysis is a life-saving treatment for individuals with end-stage renal disease (ESRD). To manage their condition effectively, patients often require medications that help control their mineral and electrolyte levels. One medication nephrologist commonly prescribes is Velphoro, also known as sucroferric oxyhydroxide. In the following, we will delve into what Velphoro is, how it works, its benefits, potential side effects, and its role in peritoneal dialysis.

What is Velphoro?
Velphoro is a phosphate binder, a type of medication used to control and reduce high phosphate levels in individuals with ESRD (that’s me). It contains the active ingredient sucroferric oxyhydroxide, which acts by binding to dietary phosphate in the gastrointestinal (GI) tract and preventing its absorption into the bloodstream.

How does Velphoro work?
When a person undergoes peritoneal dialysis, their kidneys are unable to filter waste products and excess minerals from the blood efficiently. High phosphate levels can lead to complications such as bone and cardiovascular problems. Velphoro acts as a chelating agent, binding to dietary phosphate in the gut and forming an insoluble complex that is excreted in the feces. By doing so, Velphoro helps reduce the amount of phosphate absorbed into the bloodstream.

Benefits of Velphoro:

  1. Phosphate Control: Velphoro effectively reduces serum phosphate levels, helping to prevent complications associated with hyperphosphatemia, such as bone disease and cardiovascular issues.
  2. Convenience: Velphoro is available in chewable tablets, making it easy to administer and consume. It can be taken with or immediately after meals, minimizing the chances of missed doses.
  3. Improved Quality of Life: By effectively managing phosphate levels, Velphoro helps patients maintain overall better health and well-being, enhancing their quality of life.

Potential Side Effects:
While Velphoro is generally well-tolerated, it may cause some side effects. It’s important to note that not everyone experiences these, and the severity can vary from person to person. Potential side effects may include:

  1. Gastrointestinal Issues: Common side effects include diarrhea, constipation, nausea, vomiting, and abdominal pain. These symptoms are usually mild and may resolve with continued use or dose adjustment.
  2. Discoloration of Stool: Velphoro can cause darkening of the stool due to its iron content. This change in color is harmless and should not be a cause for concern.
  3. Allergic Reactions: Although rare, some individuals may experience allergic reactions to Velphoro. Signs of an allergic reaction may include rash, itching, swelling, dizziness, or difficulty breathing. If any of these symptoms occur, immediate medical attention should be sought.

Precautions and Considerations:

  1. Drug Interactions: Velphoro may interact with certain medications, such as tetracyclines, thyroxine, and quinolones. It is crucial to inform your healthcare provider about all the medications you are taking to avoid potential interactions.
  2. Pregnancy and Breastfeeding: The safety of Velphoro in pregnant or breastfeeding individuals has not been established. Consult your healthcare provider before using this medication if you are pregnant, planning to become pregnant, or breastfeeding.
  3. Monitoring: Regular monitoring of phosphate levels is essential to ensure Velphoro effectively manages phosphate control. Your nephrologist will determine the appropriate frequency of blood tests to assess your response to the medication.

Conclusion:
Velphoro (sucroferric oxyhydroxide) is a phosphate binder commonly prescribed for individuals undergoing peritoneal dialysis. By effectively reducing phosphate levels, Velphoro helps prevent complications associated with high phosphate levels in individuals with end-stage renal disease. While it is generally well-tolerated, it is important to be aware of potential side effects and communicate any concerns to your healthcare provider. Velphoro, combined with proper dietary management and regular dialysis, is vital in enhancing the quality of life for patients undergoing peritoneal dialysis. Always consult your nephrologist for personalized advice and guidance regarding your treatment plan.

And now, folks, we know more about the big brown tabs I have been chewing with my breakfast. Life is good!

Heparin & dialysis: Part 2 of 2

November 2, 2023 / / 0 Comments

In yesterday’s blog, we looked at the background of the drug Heparin itself. In today’s blog, we will investigate its specific use for peritoneal dialysis patients.

As I did for yesterday’s blog entry, for today’s, I turned to my AI assistant, Poe. I prompted (lead graphic) it to construct a blog entry about the use of heparin by peritoneal dialysis patients with the following result:

Assistant Poe Assistant

Title: The Role of Heparin in Peritoneal Dialysis: Ensuring Optimal Treatment

Introduction

Peritoneal dialysis (PD) is a widely used renal replacement therapy that offers flexibility and convenience to patients with end-stage renal disease (ESRD). This treatment modality utilizes the peritoneal membrane as a natural filter to remove waste products and excess fluid from the body. However, to ensure the efficient functioning of the PD procedure, the use of anticoagulants, such as heparin, is often necessary. In this blog post, we will explore the significance of heparin in peritoneal dialysis and its role in optimizing treatment outcomes.

Understanding Peritoneal Dialysis

Peritoneal dialysis involves the infusion of a sterile dialysis solution into the peritoneal cavity through a catheter. The peritoneal membrane lining the abdominal cavity acts as a semipermeable barrier, allowing the exchange of waste products and electrolytes between the blood vessels and dialysis fluid. To prevent clotting and maintain the patency of the peritoneal catheter, anticoagulant agents are employed.

The Role of Heparin in Peritoneal Dialysis

Heparin, a naturally occurring anticoagulant, is commonly used in peritoneal dialysis to prevent the formation of blood clots within the peritoneal catheter and the peritoneal membrane. By inhibiting the activity of clotting factors and preventing platelet aggregation, heparin helps maintain blood fluidity, allowing for uninterrupted dialysis treatment. Heparin is typically administered as an intraperitoneal or intravenous infusion during the dwell phase of the PD cycle.

Preventing Catheter Obstruction

One of the primary benefits of heparin in peritoneal dialysis is its ability to prevent catheter obstruction. Blood clots can form around the catheter tip or within the peritoneal membrane, leading to reduced flow rates and compromised dialysis efficiency. Heparin helps to reduce the risk of clot formation by inhibiting the clotting cascade and keeping the catheter patent, ensuring optimal fluid exchange and clearance of waste products.

Maintaining Peritoneal Membrane Function

The peritoneal membrane is vital for effective solute transport during peritoneal dialysis. However, prolonged contact between the dialysis fluid and the peritoneum can trigger an inflammatory response, resulting in structural and functional changes in the membrane. Heparin has been shown to possess anti-inflammatory properties, reducing the release of pro-inflammatory mediators and preserving the integrity of the peritoneal membrane. This helps maintain the longevity of the PD treatment and improves patient outcomes.

Preventing Fibrin Formation

Fibrin, a protein involved in blood clot formation, can accumulate on the peritoneal membrane during peritoneal dialysis. This fibrin deposition can lead to fibrosis and thickening of the membrane, impairing solute transport and reducing dialysis efficacy. Heparin acts as an anticoagulant by inhibiting the conversion of fibrinogen to fibrin, preventing fibrin deposition and subsequent membrane damage. By preserving the peritoneal membrane’s functional capacity, heparin ensures efficient dialysis and prolonged therapy durability.

Considerations and Monitoring

While heparin is crucial in peritoneal dialysis, its use requires careful consideration and monitoring. Individual patient factors, such as bleeding tendencies and coagulation disorders, should be assessed before initiating heparin therapy. Regular monitoring of coagulation parameters, including activated partial thromboplastin time (aPTT), is necessary to ensure that heparin is administered at appropriate doses and to avoid the risk of bleeding complications.

Conclusion

Heparin is an essential component of peritoneal dialysis, serving to prevent catheter obstruction, maintain peritoneal membrane function, and prevent fibrin formation. Its anticoagulant properties safeguard the efficiency and longevity of peritoneal dialysis treatments, allowing patients with end-stage renal disease to receive optimal care. However, the administration and monitoring of heparin therapy require close attention to individual patient factors and coagulation parameters. By understanding the role of heparin in peritoneal dialysis, healthcare professionals can ensure the safe and effective delivery of this life-sustaining therapy.

And now we all know more about Heparin and Peritoneal Dialysis. What will tomorrow’s blog bring? You will know when I know 🙂

Heparin and peritoneal dialysis: Part 1 of 2

November 1, 2023 / / 0 Comments

In the last thirty days or so, upon the advice of my dialysis nurse, I have started to use Heparin as an additive to the dialysis fluid I employ at night. Heparin is a go-to solution to drain alarms on the Liberty Cycler. In the next two blogs, I intend first, in this blog, to present findings on the drug Heparin itself. In the following blog tomorrow, I will present findings on its use as relates to dialysis.

To ascertain a meaningful background on the drug Heparin itself, I turned to my AI assistant Poe and entered the prompt in blue below, followed by the comprehensive overview.

Assistant Poe Assistant

Title: Heparin: A Lifesaving Anticoagulant Derived from Swine

Introduction:
In the world of medicine, heparin plays a vital role as an anticoagulant. It is widely used to prevent and treat blood clots, making it an essential medication for various medical conditions. Derived from animal sources, primarily swine, heparin has a long history of use and has saved countless lives. In this blog post, we will explore the origins of heparin, its production process, who should and should not use it, and important safety precautions.

The Origin and Production of Heparin:
Heparin is a naturally occurring substance found in the bodies of mammals, including humans. However, it is primarily extracted from the mucous membranes of swine (pigs) and, to a lesser extent, from the tissues of cattle and sheep. The specific biological function of heparin in these animals is still not fully understood, but it is believed to play a role in preventing excessive blood clotting.

The production of heparin involves a complex and highly regulated process. After the animals are slaughtered, their intestinal tissues are collected and processed to extract heparin. The extracted material undergoes purification and further processing in specialized facilities to ensure its safety and efficacy. Stringent quality control measures are implemented throughout the manufacturing process to maintain high standards of purity and safety.

Who Should Use Heparin:
Heparin is commonly used in the prevention and treatment of blood clots in various medical settings. It is often prescribed to patients who are at risk of deep vein thrombosis (DVT), pulmonary embolism (PE), or who have undergone certain surgical procedures that carry a heightened risk of clot formation.

Heparin is also used in the management of acute coronary syndrome, a condition characterized by reduced blood flow to the heart. Additionally, it plays a crucial role in certain medical procedures, such as kidney dialysis and heart bypass surgery, where blood clotting must be prevented.

Who Should Not Use Heparin:
While heparin is generally safe and effective, there are individuals who should exercise caution or avoid its use altogether. People with a history of heparin-induced thrombocytopenia (HIT), a rare condition characterized by decreased platelet counts and an increased risk of clotting, should not be administered heparin due to the potential for severe complications.

Patients with uncontrolled bleeding, severe liver disease, or a known hypersensitivity to heparin should also avoid its use. It is crucial for healthcare professionals to thoroughly evaluate a patient’s medical history, existing conditions, and allergies before initiating heparin therapy.

Safety Precautions and Considerations:
When using heparin, healthcare providers must closely monitor patients to ensure appropriate dosing and optimal therapeutic effect. Regular blood tests, such as activated partial thromboplastin time (aPTT) or anti-Xa activity, are performed to assess the patient’s response to treatment and adjust the dosage if necessary.

It is important to note that heparin carries a risk of bleeding, which can range from mild to severe. Patients receiving heparin should be educated about the signs of bleeding, such as unusual bruising, prolonged bleeding from cuts, or blood in the urine or stool. If any of these symptoms occur, immediate medical attention should be sought.

Conclusion:
Heparin, derived from swine and other animal sources, has been a lifesaving medication for many patients at risk of blood clots. Its production involves a rigorous process to ensure purity and safety. While heparin is widely used and generally safe, it is important for healthcare providers to carefully evaluate patients’ medical history and monitor them closely for potential complications. By adhering to safety precautions and guidelines, heparin plays a crucial role in preventing and treating life-threatening blood clots.

Fresenius provides heparin in a case of 25 30 mL bottles, each of which is two doses, given my current dialysis prescription. Heparin is distributed by Hospira out of Lake Forest, IL 60045.

Fresenius Reports Bad News for PD Patients

October 31, 2023 / / 1 Comment

I, along with many on Peritoneal Dialysis, have been waiting patiently for Fresenius to release the replacement for the extant Liberty Cycler named Versi PD Cycler System. In a PR release last April 21, 2022, they announced FDA clearance. They positioned it as the smallest, lightest, and quietest Peritoneal Dialysis Cycler, which aimed to accelerate the adoption of home therapy.

It seems that the cart got ahead of the horse, which is not unusual. Often, marketing is turned on to push a new product before the paint is even dry on it. The recent marketing blitz about EV cars is a good recent example. They certainly have not lived up to their hype and have largely been rejected by consumers with the final say in their purchases.

At a recent meeting where I was a guest speaker, in a side private conversation with a Fresenius rep adjacent to the existing Liberty Cycler on display, I inquired about the status of the new cycler. I was informed that Fresenius has pulled the Versi, and it WILL NOT BE RELEASED. To pull the Versi was a pure business decision by Fresenius. They came to the conclusion that with seven cycler-type devices already on the market, it was not prudent to introduce an eighth.

So I guess at least for the short term, however, that is defined, we are stuck with the Liberty Cycler and all its warts. Progress, this is not!

AAR for Fort Worth Presentation

October 30, 2023 / / 1 Comment

Last Wednesday, as previously reported, I was a guest speaker at a meeting hosted by Fresenious in Fort Worth Texas. The purpose of the meeting was to provide a light form of indoctrination to a group of about sixty people facing dialysis decisions and/or their support members. Four of us provided an overview of the dialysis experience from our viewpoint. I posted on Friday’s blog the poem one of the panel members wrote as his input. The following is my takeaways plus more.

As I blogged some time ago, US Navy SEALS in presentations often use the Rule of 3. This rule states that no more than three main points should be covered or the audience will go into fade-coast with information overload. I used this Rule. I implemented the rule by employing Borton’s Reflection Model from the seventies. This model provides a simple methodology of addressing the Past, Present, and Future with What, So What, and Now What which further maps to Identifying, Understanding, and Planning actions.

For the What I explained how I ended up on dialysis via being exposed to Agent Orange in Vietnam, thus diabetes, thus dialysis. In the So What area I discussed how my wife and I had, years before actually going on dialysis, purchased our home and outfitted it to support dialysis needs. For the Now What I continued driving home the preplanning aspects of dialysis preparation.

For US Navy SEALs, the AAR, or After Action Reporting is a crucial element of any operation. AAR is a debriefing process conducted after a mission to identify strengths, weaknesses, and areas for improvement. It serves as a tool for learning, refining tactics, and enhancing operational effectiveness. Whenever my wife attends one of my presentations, we also engage in an AAR afterward so I can improve. We did so after this presentation.

AAR: I need to spend less time on my background in the Navy and get right to Agent Orange. Lengthen Now What to include what takes place after dialysis like Labs, number of visits to the clinic, when and why, and support team interfaces.

I need a stronger close. Next time, if there is one, I’m going to use the “There are three kinds of people. Those who watch what happened, those who wonder what happened, and those who make things happen.” To be successful in dialysis, you have to make things happen. You can’t just sit back and expect the medical community to make all life-changing decisions for you.

In general, the audience had a “deer in the headlights” look full of FUD – fear, uncertainty, and doubt. Their questions reflected this ranging from “What happens on the Cycler when the power goes out?” to “How clean does the dialysis room have to be?” to “Just how much room do supplies take up?” and everything in between.

It was an experience worth sharing again and I will if invited.

Dialysis, Kidney Replacement and Poetry

October 27, 2023 / / 1 Comment

This past Wednesday, I was a guest speaker at a meeting in Fort Worth, TX sponsored by Fresenius, to address some sixty or so people new to dialysis. One of the speakers, Cojack Martinez, instead of speaking extemporaneously about his experiences, read a poem from his phone that he had authored.

I thought the poem was very powerful and imparted a very deeply felt message to the assembled audience. I asked him if I could share it and he kindly agreed, including making a video with it. I dropped his words into my subscription to the AI Video app Pictory, and the results are embedded below. Below the video is depicted a text form of his poem for completeness.

My thanks to Cojack for his permission to include his words herein. On Monday I will address lessons learned from my perspective on the meeting and my presentation.

My story starts long time ago, I was born at an early age!! 3 months I lost, I was stubborn I guess, so GOD let me out of that cage!!!

I’m 2 of 3, yes the middle child, the Devil struck fast at 8, he took my Dad, GOD saved my mom, so for that we were always Straight!! 

Dang devil had jokes again at 13, diabetes came Hard n strong!!! They called me “Fatboy” for a couple of years, but the illness said FAT BE GONE!!

Dr said “gotta take care of ur self”, and of course the stubborn kicked in, I cheated the system, like the genius I am, and I thought that for sure I would win!! 

But instead all I did was destroy my insides, and best believe my dr did shout!!! 15 years turned to 10, & 10 turned to 5, and before I knew it my kidneys passed out!! 

Dialysis it is, and boy was I scared, but the clinic had me chillin by dawn!! Parkway was my spot, they made me feel safe, all the fear that I had was all GONE!! 

The devil again was playing around, told cancer to bully my sis, But GOD took her home to cure all her pain, and best believe, her down here we miss!!!

Because of all this a transfer took place, had to move closer to take care of kids!! From ft worth to granbury was gonna be the plan, be patient they said so I did!!! 

So much had to happen for this to take place, my dr was so far away!! He had to approve, there was a long list , but rome wasn’t built in a day!! 

GOD did his thang yet once again, The call came later that night!! All ducks had lined up, a miracle it was, and granbury clinic was now in my site!!! 

The staff was awesome, made me feel VIP, loved the place from the minute I walked in!!! The friends that I made, and the care that they gave, it was definitely the best place I’ve been!!!

I was put on a list bout a year or so back, a kidney was now in my cart, I knew the wait was gonna be long, But GOD got this I knew in my heart!! 

A year had past no luck on that list, then a blonde gave me info I needed!! Why ask for one part when I can get two, GOD had sent me for what I had pleaded!!! 

GOD did his thang, and yes I know, he was blessing me yet once again!! 2 weeks had past when I got the call that a kidney n pancreas was in!! 

I young man lost his life, but a hero he became, mine he will always be!! A transplant I got, no longer needed shots, but the best feeling was NOW I COULD PEE!!!

A new journey began, but I wasn’t alone, I knew that GOD had my back!!! A blonde was in site a blessing she was, but I knew I had to step up my Mac!!!

Two blessings in one can u say VIP, her daughter was one of a kind, my best friend she became I made her my wife, and both beauty’s became yes all mine!!!

My Past is the past, got in trouble at times, was considered they say a straight thug!! But what they didn’t know was that GOD took control, and faith had become my new drug!!!

Wouldn’t change it for the world, not a single thang, my life now is the results of my past!!! I’m happy not sad, I’m healed but not cured, so the devil can just kiss my ass!!!! 

Foods Now Strongly Linked to Diabetes

October 26, 2023 / / 1 Comment

A new study by Harvard researchers suggests that eating just two servings of red meat per week may increase your risk of developing type 2 diabetes. The study, published in the American Journal of Clinical Nutrition, was based on a large observational data from more than 200,000 people. The study also found that replacing red meat with plant-based protein sources, such as nuts and legumes, may reduce the chances of developing the condition.

You may ascertain for yourself from this Google link how the above research has hit the airwaves.

I find this most interesting in that my dialysis team has consistently encouraged me to eat more meat to bolster my lab readings. Seems to be yet another contradiction, doesn’t it?

Diabetes and Kidney Function: A Primer

October 25, 2023 / / 0 Comments

In my last blog, we discussed the strong and undeniable tie between Diabetes and Dialysis. In this blog, we delve into the question OK, given diabetes, what do we do regarding the need for dialysis?

There are specific guidelines and recommendations for regular monitoring of kidney function in individuals with type 2 diabetes. The goal of regular monitoring is to detect early signs of kidney damage and enable timely intervention to prevent or slow the progression of diabetic kidney disease (DKD). Here are some key guidelines:

American Diabetes Association (ADA):

The ADA recommends an annual assessment of kidney function in all individuals with type 2 diabetes.
The assessment includes measuring urinary albumin excretion (albuminuria) and estimated glomerular filtration rate (eGFR) using a blood test.
The ADA also suggests considering more frequent monitoring (every 3-6 months) in individuals with known kidney disease or those at higher risk.
National Kidney Foundation (NKF):

The NKF recommends regular screening for kidney disease in individuals with type 2 diabetes.
The screening includes measuring urinary albumin-to-creatinine ratio (UACR) and eGFR at least annually.
The NKF emphasizes the importance of early detection and treatment of kidney disease to slow its progression.
International Society of Nephrology (ISN) and International Diabetes Federation (IDF):

The ISN and IDF jointly recommend annual screening for kidney disease in individuals with diabetes.
The screening includes measuring urinary albumin excretion and eGFR.
The guidelines also highlight the importance of blood pressure control, glucose management, and lifestyle modifications to reduce the risk of kidney disease.
It’s important to note that these guidelines may vary slightly depending on factors such as individual risk profile, duration of diabetes, and comorbidities. Therefore, it is recommended to consult with a healthcare provider who can tailor the monitoring schedule based on an individual’s specific needs.

Regular monitoring of kidney function allows for early identification of kidney disease and enables healthcare providers to implement appropriate interventions, such as optimizing glucose and blood pressure control, prescribing medications (such as ACE inhibitors or ARBs), and recommending lifestyle modifications. These interventions aim to slow the progression of kidney disease and reduce the risk of complications, including the need for dialysis or kidney transplantation.

Remember, adherence to regular monitoring and ongoing communication with healthcare professionals is crucial for the effective management and prevention of kidney disease in individuals with type 2 diabetes.

In tomorrow’s blog, we will introduce current research that indicates a strong correlation between certain foods and diabetes – and it’s not candy or deserts BTW! Poe helped with this entry.

The Link Between Diabetes and the Subsequent Need for Dialysis: Understanding the Impact

October 24, 2023 / / 0 Comments

Introduction

Diabetes is a chronic disease that affects millions of people worldwide. Among its many complications, one that is particularly concerning is the potential need for dialysis. In this blog post, we will explore the relationship between diabetes and the subsequent need for dialysis. In the next several posts we will dive deeper into diabetes and its subsequent impact on kidneys often leading to the need for dialysis. The two are very intertwined and merit serious discussion and understanding.

Understanding Diabetes and Dialysis

Diabetes is a metabolic disorder characterized by high blood sugar levels. When left uncontrolled, it can lead to damage to various organs, including the kidneys. Diabetic nephropathy, also known as diabetic kidney disease, is a common complication that can progress to end-stage renal disease (ESRD), necessitating dialysis or a kidney transplant for survival. I am suffering from both.

Type 2 diabetes is a well-established risk factor for the development of kidney disease, including the need for dialysis or kidney failure. The statistical link between type 2 diabetes and these conditions is supported by numerous research studies and epidemiological data. Here, we will explore some key statistical associations:

Prevalence of Diabetic Kidney Disease: Diabetic kidney disease (DKD) is a common complication of type 2 diabetes. According to the Centers for Disease Control and Prevention (CDC), DKD accounts for approximately 44% of all new cases of kidney failure in the United States. This highlights the strong association between type 2 diabetes and the subsequent need for dialysis or kidney transplantation.

Progression to End-Stage Renal Disease (ESRD): Type 2 diabetes is a leading cause of ESRD, which is the final stage of chronic kidney disease (CKD) requiring dialysis or kidney transplantation to sustain life. Studies have shown that individuals with type 2 diabetes have a significantly higher risk of developing ESRD compared to those without diabetes. The risk of ESRD increases with the duration of diabetes and the level of glycemic control.

Incidence Rates: Epidemiological studies have consistently demonstrated a higher incidence rate of ESRD among individuals with type 2 diabetes. For example, a study published in the New England Journal of Medicine reported that the annual incidence of ESRD was 8.8 cases per 1,000 individuals with type 2 diabetes, compared to 0.3 cases per 1,000 individuals without diabetes. In layman’s terms, this translates to people with diabetes are almost 30 times more likely to suffer from ESRD (8.8/0.3 = 29.333.) This substantial difference highlights the strong statistical link between type 2 diabetes and the need for dialysis or kidney failure.

Risk Factors: Several risk factors contribute to the increased likelihood of developing kidney disease among individuals with type 2 diabetes. These include poor glycemic control, high blood pressure (hypertension), obesity, smoking, and genetic predisposition. I have hypertension treated with three meds, am a former smoker, and both my mother’s mother and my mother were diabetics. Managing these risk factors is crucial in reducing the progression of kidney disease and the subsequent need for dialysis.

Conclusion: The statistical link between type 2 diabetes and the need for dialysis or kidney failure is well-established. The prevalence, incidence rates, and increased risk of ESRD among individuals with type 2 diabetes highlight the importance of early detection, regular monitoring, and effective management of diabetes to prevent or delay the progression of kidney disease.

In forthcoming blogs, we will discuss specific guidelines and recommendations for regular monitoring of kidney function in individuals with type 2 diabetes, what lifestyle modifications play a crucial role in reducing the risk of kidney disease in individuals with type 2 diabetes, and discuss recent research on food all of us enjoy that has been found (only recently) to potentially lead to diabetes. Stay tuned. Poe was here.

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