When people are on dialysis phosphorus can build up in the blood because the kidneys no longer work or do not work well. Normal kidneys help to get rid of phosphorus. A high level of phosphorus in the blood can cause weak and brittle bones, bone pain and itching. Also, high phosphorus can cause calcium to settle inside the blood vessels. When calcium builds up in the blood vessels they can become clogged. This can cause problems for transplant surgery.
Healthy kidneys remove waste from your blood and produce hormones your body needs. If your kidneys fail, you either need a kidney transplant or dialysis. Dialysis is a procedure that uses a machine to perform many of the functions of the kidney. Dialysis can help prevent problems resulting from kidney failure and it allows people with kidney failure to live productive lives. Dialysis filters your blood, and like a health kidney, removes waste from your blood. Patients using dialysis are also required to follow a strict diet in order to stay healthy. There are two types of dialysis: hemodialysis and peritoneal dialysis. There are different advantages and disadvantages with both hemodialysis and peritoneal dialysis. Talk to your doctor about which type of dialysis would work better for you.
1 AnswerIf you are on dialysis, it’s important to shop for and prepare food carefully to avoid contamination:
- Dented or damaged cans: Do not eat foods from dented or damaged cans.
- Freshness dates: Do not use food products after their freshness date has expired.
- Raw eggs: Do not eat raw eggs or uncooked dough which contains raw eggs.
- Wash produce thoroughly with water: Use a scrub brush to remove dirt from potatoes, carrots and turnips. Peel and discard outer leaves and rinds. Wash prepackaged salad mixes and vegetables, even if the label says they are pre-washed. No soap or detergent is needed.
- Purchase fresh produce: Do not buy any produce which is bruised, shriveled, moldy or slimy. Buy only what you can use within a few days.
- Thaw frozen foods in the refrigerator, not on the counter.
- Separate your cutting boards: Use one board for raw meat, poultry and fish and use another board for salads and other foods.
- Buy fresh fish: Seafood should have a clean smell. The fish eyes should be clear, shiny and bulging (not sunken).
1 AnswerIf you are on dialysis, it’s important to handle food carefully to avoid contamination:
- Wash your hands with soap and warm water before and after handling food.
- Promptly wash cutting boards, plates and counter tops that come in contact with meat juices or raw meat. Use hot, soapy water. To sanitize after cleaning, put items through the automatic dishwasher or rinse them in a solution of 1 teaspoon of chlorine bleach and 1 quart of water.
- Handle raw meat, poultry, seafood and eggs as if they were contaminated with bacteria. Even if they do not start out with enough bacteria to make you sick, if mishandled they could.
1 AnswerFluid build-up caused by dialysis treatments can lead to:
- high blood pressure
- shortness of breath
- heart failure
- muscle cramping
- low blood pressure
1 AnswerIf you are on dialysis and want to travel, consider the following tips:
- Hand-carry essential medical information, your medicines, and other medical supplies in case of the unexpected, such as lost luggage.
- Bring enough of your medications to last for your entire trip, with enough extra to deal with possible emergencies. Also carry written prescriptions just in case.
- If you need extra assistance boarding a plane or train, inform personnel when you check in so they can give you special instructions.
- If you are planning to travel by plane or train, make arrangements for any special meals such as low-salt, low-fat or diabetic, at the time that you make your reservations.
- When making a hotel reservation, you can request a first-floor room or a handicapped-accessible room, if stairs or distances are a problem.
- If you use a travel agent, tell the agent about any special needs you may have, such as special meals, accessible rooms and assistance while changing planes. The agent can also advise you about special considerations regarding safe transport of dialysis supplies while traveling to foreign countries.
1 AnswerIf you are on dialysis, Medicare is your primary insurance coverage when you travel. Medicare will pay for 80% of your treatment costs within the U.S. and its territories. You will be responsible for the remaining 20% not covered by Medicare. If you have secondary insurance, it may cover this 20%. However, you may have to pay this 20% ""up front"" and bill your insurance later. Check with the transient dialysis center about its policy on this. Most state Medicaid programs will not pay for treatment outside of your home state.
If you have commercial insurance as your primary insurance, you may need to request a letter from your insurance company stating it will pay for your treatment at the transient dialysis center. Some commercial insurance will pay for dialysis outside of the U.S. Transient dialysis centers will often call and verify this coverage themselves. Be sure to allow enough planning time to make these arrangements.
A doctor's fee may also be charged by the transient dialysis center. Be sure to ask what portion of this charge will be your responsibility.
1 AnswerPeople on peritoneal dialysis are not dependent on the availability of a dialysis unit. However, you will still need to plan ahead and arrange for back-up medical care for your trips, as do people on hemodialysis. Typically, this would mean contacting a dialysis center in the area and asking if they would be available should a problem arise. The center may request a copy of your medical records in advance. You should always carry a copy of your records with you as well.
People who do continuous ambulatory peritoneal dialysis (CAPD) should carry enough supplies for the length of the trip, plus some extra supplies in case of problems. For longer stays, it may also be possible to arrange for delivery of supplies to your destination. Make sure these supplies have arrived before you leave for your trip. People on CAPD also need to plan for adequate clean space where they can do their exchanges while traveling.
People who do automatic peritoneal dialysis (APD) and who plan to travel for one week or longer can arrange for supplies to be delivered to their destination. Smaller cycler machines are now available, which are easy to carry on airplanes and use in hotel rooms and campers.
1 AnswerYou can do home hemodialysis when you are traveling, although most people make arrangements for in-center treatment. People who wish to continue doing their own treatment should check with their dialysis care team about doing home dialysis away from home.
Some people travel with their machines, supplies, and portable water treatment equipment. An example would be people who have dialyzed at campsites that are equipped with hook-ups for electricity.
Even if you do your own treatment, it is important to know the location of the closest dialysis center if you need assistance. Let the center know when you will be in the area, and ask if they would be willing to provide medical assistance, if needed. Carry complete medical information with you. Remember that most dialysis and equipment companies have toll-free numbers for assistance 24 hours a day. Carry these numbers with you.
1 AnswerIt is possible that you may unexpectedly require hospitalization when you are traveling. If this should happen, your transient doctor is prepared for this possibility and will care for you during your hospital stay. He or she will probably talk to your regular doctor to coordinate your care. You may feel more comfortable knowing that this coordination has taken place.
Before you begin your trip, you will most likely have a doctor assigned to you by your transient dialysis center. Find out how to contact the doctor when you first arrive. If you do become ill, call the dialysis center or doctor as instructed.
Being hospitalized while away from home can be a stressful experience for anyone, and it certainly can change your travel plans. Preparing ahead for this possibility can help make the experience less stressful. The following suggestions may be helpful:
- Make sure your family knows your travel plans.
- Make sure you have important phone numbers, such as your regular doctor and dialysis center. Have a copy of your medical records with you while traveling.
- Make sure anyone who is traveling with you knows where you keep your records and your medical needs.
- Make sure to bring enough medications for the entire trip, with enough extra for possible emergencies, such as lost luggage. Also carry written prescriptions, just in case.
1 AnswerYou may want to ask the following questions when making your arrangements for hemodialysis when traveling:
- What is the average treatment length of dialysis at the center?
- Can they provide the treatment time your doctor has prescribed?
- What are the hours and days of operation? Traveling patients are often placed on an evening shift, which could end as early as 7:30 pm or as late as 2:00 am.
- What types of dialyzers are used?
- Do they have the same type of dialyzer that you use at your home center?
- What types of dialysis machine does the center have (conventional, high flux capability)?
- Does the center routinely provide lidocaine?
- Are people permitted to eat or drink while on dialysis?
- Is an ice machine available?
- Is public transportation available to get to the center?
- How many people are assigned to each nurse or patient care technician?
- Can you get all the medications you get at your home center during dialysis?