Tag: PD (Page 30 of 49)

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:

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 🙂

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.

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.

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.

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!!!! 

On October 11, 2023, MarketWatch, among many other news outlets, reported the trial success of Novo Nordisk’s hit drug Ozempic against kidney failure. Fresenius shares dropped by almost one-fourth as a result. Luckily, we sold our 500 shares of Fresenius (FMS) back on August 11, 2023, when it was trading at $26.16 for over $4000.00 capital gain.

You may read the original Marketwatch article cited here, and more general reporting at the link in the lead sentence. The point of this short blog entry is to apprise readers of changes afoot in the dialysis arena. The train is coming!