Health & Wellbeing July 2013

July-Meeting

At today’s meeting we were given a very interesting talk by John Champion who is the chairman of the SCKPA (Six Counties Kidney Patients Association)

He explained that they support kidney patients and their families. The SCKPA covers members from the area served by the Oxford Radcliffe Hospital N.H.S. trust and its successors (Oxon, Northants, Bucks, Berks and parts of Wilts and Glos)

Most people with kidney disease have no symptoms because the body can tolerate even a large reduction in kidney function. In other words, we are born with a lot more kidney function than is necessary for survival. Kidney function is often sufficient if only one kidney is working.

A change in kidney function is usually discovered through a routine blood or urine test. If you are diagnosed with kidney disease, your kidney function will be monitored with regular blood tests, and treatment aims to keep any symptoms to a minimum.

If the kidneys continue to lose function and there is progression towards kidney failure, this will usually be tracked by blood tests and monitoring.

Dialysis is a form of treatment that replicates many of the kidney’s functions. It is often used to treat advance chronic kidney disease, where the kidneys have lost most or all of their function. This is known as kidney failure or end stage renal disease. If your kidneys stop working properly, waste products build up and cause symptoms including:vomiting: itchy skin: fatigue: blood in the urine.

Without necessary treatment such as dialysis, kidney failure will eventually prove fatal.

Many people will remain on dialysis on a long-term basis (possibly for the rest of their lives) but for a significant minority the goal will be a kidney transplant.

Haemodialysis is the type of dialysis that most people are aware of. It involves inserting a needle, which is attached by a tube to a dialysis machine, into a blood vessel.

Blood is transferred from your body into the machine, which filters out waste products and excess fluids. The filtered blood is then passed back into your body.

Most people require three sessions a week, each lasting four hours.

Peritoneal dialysis is a less well known type of dialysis, but it’s becoming more common. It involves using the peritoneum as a filter. To explain this John had brought along Mike Pitcher to show and explain how this works. The peritoneum is a thin membrane that lines the inside of the abdomen and surrounds and supports the abdominal organs, such as the stomach and liver. Like the kidneys, the peritoneum contains thousands of tiny blood vessels, making it useful as a filtering device.

During peritoneal dialysis, a small flexible tube, known as a catheter, is attached to an incision in your abdomen. A special fluid called dialysis fluid is pumped into the space that surrounds your peritoneum (the peritoneal cavity).

As blood moves through the peritoneum, waste products and excess fluid are moved out of the blood and into the dialysis fluid. The dialysis fluid is then drained from the cavity.

The process of peritoneal dialysis lasts roughly 30 to 40 minutes and is repeated around four times a day. Alternatively, you can run it overnight.

John explained that they needed to raise more funds for the future for new facilities such as a new renal ward but they put most of the focus on patient support. Many interesting questions were asked during the talk and we had an impromptu collection. Along with the donation from the group amounted to £85.50. A very interesting afternoon was had by all.

How does haemodialysis work?

Blood taken from the body to be cleaned in a filter known as a dialyser (artificial kidney). A dialyser works on the principle of blood flowing along one side of a semi-permeable membrane made of cellulose or a similar product, with the dialysate flowing along the other side. The dialysate contains a regulated amount of minerals normally present in the blood, but in renal failure they are present in excess. The membrane has tiny holes of different sizes so that the excess fluid and substances in the blood pass through at different rates, small molecules quickly and larger ones more slowly, to be taken away in the dialysate until a correct balance in the blood is achieved.

A kidney machine regulates blood flow, pressure and the rate of exchange.

As only a very small amount of blood is in the dialyser at any given time, blood needs to circulate from patient to dialyser to patient for about 4 hours. Treatment is usually 3 times per week. The time and strength of dialysis can be programmed for each patient.

Blood is carried from the patient to the dialyser and returned through dialysis lines (plastic tubes) which are connected to the patient in one of two ways:

Fistula

The joining of a vein and artery just under the skin, usually on the forearm makes the vein swell to allow needles to be inserted and removed after each treatment. Between treatments only a small scar and swelling are visible.

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