Dialysis + Kidney transplant

Question 1

What are the 2 main methods for Dialysis?

Answer 1

Hemodialysis

Peritoneal Dialysis

Question 2

What are some of the cons of Hemodialysis?

Answer 2

Generally, requires dialysis centre visits (can also be performed at home).

Question 3

How often do you need Hemodialysis?

Answer 3

3-4.5 hours of treatment 3 times per week. Allows for 4 treatment free days per week.

Question 4

What are the dietary restrictions with Hemodialysis?

Answer 4

Strict dietary constraints and salt/water intake restrictions.

Question 5

What access is needed for Hemodialysis?

Answer 5

Needs access – ideally an arteriovenous fistula (requires an operation under local anaesthetic) or tunnelled central venous line (latter carries risk of bacteraemia if become infected).

Question 6

What is a benefit of Peritoneal dialysis?

Answer 6

Performed at home, generally overnight. Saves journey time and travel requirement.

Can travel easily – machine packs into a wheelie suitcase and fluids delivered by the companies internationally.

Day time Exchanges can be done anywhere – at work etc just need to be able to wash hands.

Question 7

How often do you need Peritoneal dialysis?

Answer 7

Normally 7 days a week but can often have a weekend off if needed.

Question 8

What are the dietary restrictions for Peritoneal dialysis?

Answer 8

Lesser constraints for food and water intake.

Question 9

What is a risk factor with peritoneal dialysis?

Answer 9

Chance of infection(s) due to catheter or such as peritonitis.

Question 10

What factors should be considered when making a kidney match?

Answer 10

Family history of kidney disease
Age
Comorbidities
Kidney match - Blood type abnormality, HLA Typing, Serum crossmatch.
Future pregnancy
Mental health history
Financial stability
Two healthy kidneys - Normal size, function, no blood in urine.

Question 11

What are the general post-transplant surgery recommendations?

Answer 11

AVOID;
Live vaccines
Alcohol
NSAID's
Recreational drugs
Herbal medicine
Smoking
GIVE;
Flu jabs
Immunosuppressive medications
Antibiotics

Question 12

What are the Dietary recommendations post transplant surgery?

Answer 12

AVOID;
Raw eggs, raw meat, undercooked fish and unpasteurized cheeses.Food items that can interact with Tacrolimus (immunosuppressant) – Seville oranges, marmalade made from Seville O, Earl grey tea, grapefruit.

DO;
Low salt & sugar diet
Regular Fluid intake

Question 13

How should risk factors be managed post-transplant?

Answer 13

Diabetes - diet, lifestyle

Cardiovascular disorders - Measure + manage BP, lifestyle

Cancer - Use sunscreen, cover up, Regular skin checks, breasts

Psychiatric disorders - Being mindful/seeking help