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    What are my kidneys and what do they do?

    You have two kidneys. The kidneys are shaped like beans. Each kidney is about the size of a fist. They are located just below your ribcage, one on each side of your spine. Your kidneys filter your blood. Each kidney is made of 1 million little filters. During every minute of every day, these filters take out waste materials that can hurt you. They also take out extra fluid from your blood. The wastes and extra fluid make urine. The urine flows from your kidneys to your bladder through tubes called ureters.The bladder stores urine until you urinate. Then, urine leaves the body through a tube called the urethra.

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    What is kidney failure?

    Kidney failure means your kidneys no longer filter your blood well enough to keep you healthy. Failing kidneys do a poor job of removing wastes and extra fluid from your blood. Wastes and extra fluid begin to build up. The buildup of wastes can make you sick. You may have the following symptoms: ankle, face, or belly swelling; stomach sickness; throwing up; loss of appetite; loss of sense of taste; feeling tired; weakness; confusion; headaches.

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    What are the most common causes of kidney failure?

    Diabetes and high blood pressure are the most common causes of kidney failure. Other factors include heart and blood vessel disease and a family history of kidney failure. African Americans, Hispanics/Latinos, and American Indians are more likely to have kidney failure.

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    Is dialysis a cure for kidney failure?

    No. Hemodialysis and peritoneal dialysis help you feel better and live longer; however, they do not cure kidney failure. Although people with kidney failure are now living longer than ever, over the years kidney disease can cause problems such as heart disease, bone disease, arthritis, nerve damage, infertility, and malnutrition. These problems won’t go away with dialysis; however, doctors now have new and better ways to prevent or treat them. You should discuss these problems and their treatments with your doctor.

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    What are the treatments for kidney failure?

    The treatments for kidney failure are: hemodialysis; peritoneal dialysis; a kidney transplant.

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    What is hemodialysis?

    Hemodialysis is a treatment for kidney failure that is done in a center several times per week. Some people learn to do hemodialysis in their homes. Hemodialysis uses a machine to filter your blood when your kidneys are too sick to filter any more. With hemodialysis, your blood is filtered outside of your body. Unfiltered blood is removed from the body and flows to the dialyzer to be cleaned. Filtered blood flows back to the body. First, a dialysis nurse places two needles into your arm. A pump on the hemodialysis machine draws your blood through one of the needles into a tube. The tube takes the blood to a filter, called a dialyzer. Inside the dialyzer, your blood flows through thin fibers that are like straws. The wastes and extra fluid leave the blood through tiny holes in the fibers. Then, a different tube carries the filtered blood back to your body through the second needle. The hemodialysis machine throws out the wastes and extra fluid, just like how your body makes urine. Hemodialysis does not make the kidneys better. However, it may help you feel better by filtering your blood when your kidneys fail.

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    What is peritoneal dialysis?

    Peritoneal dialysis uses the lining of your belly to filter your blood inside your body. You can do peritoneal dialysis at home because it uses your body to filter. A doctor will place a soft tube called a catheter in your belly a few weeks before you start treatment. The catheter stays in your belly permanently. The catheter lets you put a kind of salty water from a plastic bag into your belly. Then, you can move around and go about your day. While the salty water is inside your belly, it soaks up wastes and extra fluid from your body. After a few hours, you drain the salty water from your belly into a drain bag. The salty water removes wastes and extra fluid from your body. The salty water can be thrown away into a toilet or tub. Then you start over with a fresh bag of salty water. You will empty and fill your belly four to six times a day. The salty water is always in your belly soaking up wastes and extra fluid. Peritoneal dialysis does not make the kidneys better. However, it may help you feel better by filtering your blood when your kidneys fail.

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    What is a kidney transplant?

    A kidney transplant places a healthy kidney from another person into your body. The kidney may come from someone who has just died. Your doctor will place your name on a waiting list for a kidney. A family member or friend might be able to give you a kidney. Then you don’t have to wait. Once it is placed inside your body, the new kidney takes over filtering your blood. The damaged kidneys usually stay where they are. The new kidney is placed in the front-lower abdomen, on one side of the bladder. Your body normally attacks anything that shouldn’t be there, such as bacteria. The body will think the new kidney shouldn’t be there. You will take medicines called immunosuppressants to keep your body from attacking the new kidney.

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    What causes chronic kidney disease?

    Chronic kidney disease (CKD) is a long, usually slow, process where the kidneys gradually lose function. In the beginning, you may not have noticed that you are suffering from chronic kidney disease. The early signs can be subtle, so you may not notice you had symptoms. The diagnosis of kidney failure is usually made through blood tests measuring BUN, creatinine and glomerular filtration rate (GFR). The blood test estimates how much blood passes through the glomeruli each minute. Glomeruli are the tiny filters in the kidneys that remove waste from blood. Chronic kidney disease can be classified in 5 stages. The disease can take years to go from below normal kidney function (CKD stage 1) to Chronic Kidney Failure (CKD stage 5). The chronic form is permanent kidney damage caused, for example, by diabetes, high blood pressure (hypertension), various kidney tissue infections (glomerulonephritis) and excessive use of some medications that may reduce long-term kidney function. Since it may be possible to slow down the progression of the disease in early stages, it is vital to get an early diagnosis and to work closely with your doctor to find the right treatment.

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    What lifestyle changes may reduce the progression of chronic kidney disease?

    Control high blood pressure, blood sugar; Eat a healthy diet (or lower-protein, or lower salt diet); Lose weight; Start 3 x 30 min aerobic workouts; Quit smoking; Avoid certain pain medications. But always follow your doctors advice, and follow medical advice, before undertaking any major changes.

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    When is dialysis needed?

    Worldwide more than 2,500,000 patients undergo dialysis because of chronic kidney failure. The stage of ‘kidney failure’ is reached when both kidneys stop, or have almost stopped doing their normal work (with less than fifteen percent of the kidney's normal functions remaining). If kidney disease progresses to this stage, waste products from normal body functions and excess fluid (for example, from drinking) accumulate in the body. As a consequence, toxins and water must be removed from the body with a blood purification procedure. This procedure is what's called dialysis. Chronic kidney failure is treatable. And there are three basic types of treatments available, depending on physical constitution and any underlying diseases: transplantation, hemodialysis, peritoneal dialysis.

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    Do I have to stop working?

    You can return to work or continue education while on dialysis. If you are treated in a dialysis center, you will be given a treatment plan that fits your work or education schedule. Another alternative is home hemodialysis or peritoneal dialysis, which allow for more flexibility in schedules.

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    Is dialysis painful?

    During dialysis you may feel a pinch when each of the needles go in. There are skin numbing drugs that can help. The rest of your dialysis treatment should not hurt. If it does, tell your staff member so they can fix it.

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    What can I drink and eat as a dialysis patient?

    You will need to follow a special diet. There are different diets for PD and HD patients. Ask your nephrologist for advice. Eating healthy foods can help you keep up your energy and strength. All dialysis and transplant centers have a dietitian. The dietitian helps people with kidney failure learn about healthy food choices. You should talk with your center’s dietitian to make a meal plan. The best diet for you will depend on which kidney failure treatment you choose after talking with your doctor.

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    What to eat and drink while on hemodialysis

    Limit how much liquid and water you drink. Fluid can build up in your body between hemodialysis sessions. Also, many foods contain water. The extra fluid in your body can cause swelling and high blood pressure. Extra fluid in your body makes your heart work harder. Many foods contain water. Limit sodium, or salt. Watch out for sodium in frozen foods and prepared meals. You can also find sodium in canned foods, hot dogs, and fast food. Sodium makes you thirsty, which makes you drink more water and other liquids than you should. Limit potassium. Potassium is found in many fruits and vegetables such as potatoes, tomatoes, oranges, and bananas. Too much potassium can make your heart beat unevenly. Hemodialysis does not remove potassium from your body well. Eat protein-rich foods such as meat, fish, and eggs. Hemodialysis removes protein from your body. Limit phosphorus. Phosphorus helps your bones, blood vessels, and muscles work. However, too much phosphorus can make your bones weak. Limiting phosphorus can be hard. Foods that contain phosphorus, such as meat and milk, also contain protein that you need. You should be careful to eat enough protein, yet not so much that you get too much phosphorus. You can avoid other foods that contain phosphorus, such as cola, tea, beans, and nuts. Find healthy ways to add calories to your diet. Calories are found in all foods and give your body energy. Many people on hemodialysis do not have a good appetite and do not get enough calories. Vegetable oils are good sources of calories. Vegetable oils include olive oil, canola oil, and safflower oil. Use them on breads, rice, and noodles. Hard candy, sugar, honey, jam, and jelly provide calories and energy. However, if you have diabetes, speak with your doctor or dietitian before eating extra sweets.

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    What to eat and drink while on peritoneal dialysis

    Drink as much water and other liquids as you need. If you are holding too much fluid or too little fluid, your doctor needs to know. Limit sodium to control your thirst and help prevent heart problems. You can use spices other than salt to flavor your food. You may need to eat more potassium-rich foods. Peritoneal dialysis removes potassium from your body. Talk with your doctor or dietitian about the right amount of potassium for you. Eat protein-rich foods. Peritoneal dialysis removes even more protein from your body than hemodialysis. Limit phosphorus to keep your bones strong. You may need to limit your calorie intake. The salty water also contains some sugar. Your body absorbs the sugar, which can cause you to gain weight.

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    Eating, Diet, and Nutrition for patients with kidney transplant

    Limit sodium to help prevent heart problems. You should be able to eat normal amounts of phosphorus and potassium. You may need to adjust the amounts if blood tests show a problem. Eat protein-rich foods to repair muscle breakdown and protect against infection. You may need to limit your calories. The medicines you take can make you gain weight.

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    How does what I eat and drink affect my hemodialysis?

    Your choices about what to eat and drink while on hemodialysis can make a difference in how you feel and can make your treatments work better. Between dialysis treatment sessions, wastes can build up in your blood and make you sick. You can reduce waste buildup by controlling what you eat and drink. You can match what you eat and drink with what your kidney treatments remove. Some foods cause wastes to build up quickly between your dialysis sessions. If your blood contains too much waste, your kidney treatment session may not remove them all.

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    Do I need to watch what I eat and drink?

    Yes. You will need to carefully plan your meals and keep track of the amount of liquids you eat and drink. It helps to limit or avoid foods and beverages that have lots of potassium, phosphorus, sodium—for example, vegetable juice and sports drinks.

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    Why is it important to keep track of how much liquid I eat or drink?

    You may feel better if you keep track of and limit how much liquid you eat and drink. Excess fluid can build up in your body and may cause swelling and weight gain between dialysis sessions; changes in your blood pressure; your heart to work harder, which can lead to serious heart trouble; a buildup of fluid in your lungs, making it hard for you to breathe. Hemodialysis removes extra fluid from your body. However, hemodialysis can remove only so much fluid at a time safely. If you come to your hemodialysis with too much fluid in your body, your treatment may make you feel ill. You may get muscle cramps or have a sudden drop in blood pressure that causes you to feel dizzy or sick to your stomach. Your health care provider can help you figure out how much liquid is right for you. One way to limit how much liquid you have is to limit the salt in the foods you eat. Salt makes you thirsty, so you drink more. Avoid salty foods such as chips and pretzels. Your renal dietitian will give you other tips to help you limit how much liquid you consume while making sure you don’t feel too thirsty.

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    What foods count as liquid and why?

    Foods that are liquid at room temperature, such as soup, contain water. Gelatin, pudding, ice cream, and other foods that include a lot of liquid in the recipe also count. Most fruits and vegetables contain water, such as melons, grapes, apples, oranges, tomatoes, lettuce, and celery. When you count up how much liquid you have in a day, be sure to count these foods.

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    What do I need to know about potassium?

    Healthy kidneys keep the right amount of potassium in your blood to keep your heart beating at a steady pace. Potassium levels can rise between hemodialysis sessions and affect your heartbeat. Eating too much potassium can be dangerous to your heart and may even cause death. To control potassium levels, limit potassium-rich foods such as avocados, bananas, kiwis, and dried fruit. Choose fruits and vegetables that are lower in potassium. Have very small portions of foods that are higher in potassium, such as one or two cherry tomatoes on a salad or a few raisins in your oatmeal. You can remove some of the potassium from potatoes by dicing or shredding them and then boiling them in a full pot of water. To remove some of the potassium from potatoes:-Dice potatoes into small pieces or grate potatoes into shreds and then boil potatoes in a full pot of water. Your renal dietitian will give you more specific information about the potassium content of foods.

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    What do I need to know about protein?

    Renal dietitians encourage most people on hemodialysis to eat high-quality protein because it produces less waste for removal during dialysis. High-quality protein comes from meat, poultry, fish, and eggs. Avoid processed meats such as hot dogs and canned chili, which have high amounts of sodium and phosphorus.

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    What do I need to know about sodium?

    Sodium is a part of salt. Sodium is found in many canned, packaged, frozen, and fast foods. Sodium is also found in many condiments, seasonings, and meats. Too much sodium makes you thirsty, which makes you drink more liquid. Try to eat fresh, naturally low-sodium foods. Look for products labeled “low sodium,” especially in canned and frozen foods. Do not use salt substitutes because they contain potassium. Talk with your renal dietitian about spices you can use to flavor your food. Your renal dietitian can help you find spice blends without sodium or potassium.

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