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Renal Failure: Are You in Renal Failure. Lets Learn and Research the Disease

Updated on August 24, 2017

Slowing the Progression of Chronic Kidney Disease

There are many ways to help delay or prevent kidney failure, especially when chronic kidney disease (CKD) is diagnosed in the earlier mild to moderate stages of CKD. Because chronic kidney disease usually occurs gradually over time, finding out you have kidney disease in the early stages provides an opportunity to slow the progression of CKD.

Blood pressure control

Study after study has confirmed that good blood pressure control can help slow the rate of kidney disease. This is especially true in people who have diabetes and protein in the urine (proteinuria). In addition to helping prevent kidney failure, keeping blood pressure under control also helps prevent heart disease and stroke.

According to National Kidney Foundation (NKF) guidelines, you should strive to keep your blood pressure at or below 130/85 if you have kidney disease. If you have diabetes and/or proteinuria too, their suggested target blood pressure is 125/75.

Keep your blood pressure at 130/85 or lower if you have kidney problems but not diabetes.

Keep your blood pressure at 125/75 or lower if you have diabetes and/or protein in your urine.

Lifestyle changes such as losing weight, exercising, meditating, eating less salt and drinking less alcohol can help lower your blood pressure. Smoking is a risk factor for faster progression of kidney disease, so stopping smoking can also help slow progression.

Blood pressure medicine

Two types of blood pressure medicines slow the action of angiotensin, a substance that may contribute to kidney disease progression. Angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are the two types of high blood pressure medicines. The generic names of some common ACE inhibitors are captopril, enalapril, and lisinopril. Some common ARBs are losartan, candesartan, and valsartan.

If you are diagnosed with high blood pressure, your doctor will prescribe blood pressure medicine for you to take as directed to control blood pressure and help slow the rate of kidney disease. If you have diabetes and have normal blood pressure, your doctor may still prescribe blood pressure medicine because studies have shown that angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) can help slow rate of kidney disease in people with diabetes, even if they do not have high blood pressure.

Other types of blood pressure drugs such as a diuretic (water pill) or a calcium-channel blocker may be added, as needed.

Ask your doctor what you can do to keep your blood pressure at a healthy level.

Blood glucose control

If you have diabetes, strict controls of your blood glucose levels can help slow the progression of kidney disease.

Keep your hemoglobin A1c, which measures blood glucose control over the last two to three months, to less than 6.5%.

To reach this level of strict glycemic control, you will need to monitor your blood glucose closely to avoid hypoglycemia.

You may need to use frequent insulin injections or an insulin pump. Talk to your doctor about your diabetes treatment options.

Diet and lifestyle

Ongoing research continues on dietary changes and drugs that may help to slow the progression of kidney disease. Examples include:

Fish oil for IgA nephropathy

Pirfenidone (an anti-fibrotic drug) in the treatment of focal segmental glomerulosclerosis (FSGS)

Dietary intake of antioxidant or anti-inflammatory vitamins and foods

Some studies have shown that limiting protein and phosphorus in the diet can help slow kidney disease progression. Talk to a renal dietitian about your CKD non-dialysis diet and recommendations to prevent kidney failure.

Repairing kidney damage

In some cases, the kidney disease itself can be treated. If you have an obstruction that blocks your urine flow, surgery may help. If you have an infection, antibiotics may clear it up.

If your kidney damage is due to the effects of prescription or non-prescription medicines, your doctor may be able to suggest a different drug that is less harmful to your kidneys. If you have kidney disease and are prescribed antibiotics talk to your doctor about the effect it may have on your kidneys. Painkillers (even over-the-counter medicines) can cause damage your kidneys. Talk to your doctor about all medicines you take. Sometimes diagnostic lab tests are ordered with contrast dye. It may be necessary for you to have the test, but first find out if there are alternative methods as contrast dye can be harmful to kidneys.

Some diseases, such as IgA nephropathy, glomerulonephritis, and lupus can cause kidney damage when your immune system overreacts and inflammation occurs. It is sometimes possible to slow the disease process by controlling the immune system with steroids and/or other medicines.

Talk with your doctor to find out what you can do to help to slow the progress of your kidney disease.

Kidney Disease Symptoms

Focal Segmental Glomerulosclerosis

Your kidneys are part of a blood-filtering system that eliminates waste products from the body. A type of kidney disease called focal segmental glomerulosclerosis (FSGS) interferes with that system. FSGS produces scars within the kidneys, causing them to lose the ability to work. Learn more about the causes and symptoms of FSGS, as well as the treatments for this disease.

Understanding Chronic Kidney Disease

After being diagnosed with chronic kidney disease it's important to learn all you can about the disease and how to treat it. A better understanding will help make it easier to talk to your doctor and make decisions about your health.

What Is Glomerulosclerosis?

Glomerulosclerosis is the scarring of the kidney’s tiny filtering units called glomeruli. Glomerulosclerosis can be caused by varying types of kidney conditions. Often the cause of glomerulosclerosis is not known. Discover the signs and symptoms of glomerulosclerosis, as well as the treatment.

Restless Leg Syndrome and Chronic Kidney Disease

Are there times when you feel an uncomfortable or unpleasant sensation in your legs and get the urge to move them? If this happens when you are trying to relax or fall asleep, you may have a condition called restless leg syndrome (RLS). Many people with chronic kidney disease and those on dialysis have reported having a problem with restless leg syndrome. Restless leg syndrome is annoying and it can prevent you from getting an adequate amount of sleep. Learn more about restless leg syndrome, its causes and what can be done to help you get the rest you need.

Inflammation and Chronic Kidney Disease

Inflammation is the body’s response to help fight off foreign substances, such as viruses, bacteria and injury. However, sometimes inflammation can become a problem and damage the tissues in the body. For chronic kidney disease patients on dialysis, inflammation can lead to poor appetite, poor nutrition and cardiovascular disease. Learn about inflammation, how it affects people with chronic kidney disease and how to treat it.

Infections and Chronic Kidney Disease

Your body fights infections continually; whether it’s the redness around a small cut on your finger or a common cold. But if an infection grows faster than your immune system can fight it, your body can be overwhelmed. If you have chronic kidney disease, your ability to fight infection may be weakened because of your condition. What can you do to keep yourself infection free? Learn more about infections, how they can affect people with renal disease and what you can do to boost your body’s immune system.

Hair, Nails and Chronic Kidney Disease

Appearance is important to many people. So when a person with chronic kidney disease goes through changes like hair loss or nail discoloration, it can be uncomfortable. Learn how your hair and nails may visibly change with chronic kidney disease and dialysis, and how you can help get them healthy.

Eyes and Chronic Kidney Disease

Many people consider sight the most important of the five senses. Without the ability to see, day-to-day tasks can be difficult, frustrating and dangerous. Patients with chronic kidney disease may be surprised to discover that vision can be affected by their condition. Learn what you can do to protect your eyesight and the health of your eyes.

Dental Health for People with Kidney Disease

When was the last time you saw your dentist? Good oral health can help prevent dental problems such as tooth decay, tooth loss and gum disease. More than that, good dental health is important to avoid other complications for people with chronic kidney disease. Learn more about why taking care of your teeth is important, especially if you have kidney disease.

Chronic Kidney Disease and Your Heart

If you have chronic kidney disease (CKD), you’re probably concerned about the health of your kidneys and how well they are functioning. But your kidneys aren’t the only organs at risk. Your heart and blood vessels can become damaged as a result of CKD or as a result of the underlying conditions that caused your renal disease. Find out about the risk of cardiovascular disease and what you can do to help the health of your blood vessels and heart.

Most Common Questions Kidney Patients Ask Doctors

Dr. Kristensen is an accomplished DaVita nephrologist. She has written a special guest article for Dr. Kristensen answers some of the more common questions she is asked when meeting with a kidney patient for the first time.

Who Gets End Stage Renal Disease?

End stage renal disease (ESRD) is the final stage of chronic kidney disease (CKD) when dialysis or a transplant is needed to stay alive. But who gets ESRD? Find out what leads to ESRD and if you are at risk.

What Is Glomerulonephritis?

Glomerulonephritis, also called glomerular disease, is a type of kidney disease in which the kidneys’ filters become inflamed or damaged. It is the third leading cause of end stage renal disease (ESRD) in the United States. There are many different causes of glomerulonephritis, including infections or autoimmune diseases such as lupus, and it can come on slowly or quickly. In some cases, glomerulonephritis can lead to ESRD and dialysis. Learn more about the causes, symptoms, diagnosis and treatment of glomerulonephritis.

What Is Creatinine?

Have you ever heard your doctor or nurse discuss your creatinine level? Creatinine is a chemical waste product that is released into the blood when muscles contract. With good kidney function, creatinine is filtered from the blood through the kidneys. When creatinine levels are high, it can be an indicator of kidney disease. Doctors will order a blood test for serum creatinine levels to determine kidney function and use the number to calculate glomerular filtration rate (GFR), which can determine the stage of chronic kidney disease.

Use of Radiological Tools for Evaluating Kidney Disease

Advances in medicine are not only used to treat diseases, but also to diagnose them. Radiological tools, including x-rays, ultrasound, computerized tomography (CT) and magnetic resonance imaging (MRI), may be tests you have undergone. DaVita nephrologist, Dr. Purushottama Sagireddy, shares the various radiological tests doctors use to diagnose kidney disease and explains what information is provided by each test.

Understanding Your Lab Work

GFR. Kt/V. BUN. CCr. This alphabet soup represents important tests given to people with chronic kidney disease. These tests and others tell you and your health care team how well your kidneys are working and if your treatment plan is effective. Understanding what these tests measure and what the results mean can help you manage your condition.

Renal Cancer and Chronic Kidney Disease

Renal cell cancer (RCC), or kidney cancer, is an abnormal mass or tumor growing in the kidney. It may spread to other parts of the body, most often the bones or lungs. Learn more about RCC.

Kidney Stones and Chronic Kidney Disease

Kidney stones, if left untreated, can lead to more serious kidney problems such as chronic kidney disease. Treatment of kidney stones and taking steps to prevent recurrence can reduce the risk of kidney stones progressing to disease.

Learn More »causes, symptoms and treatment of acute kidney failure and how it may be prevented.

Are you in Renal Failure?


I myself am in Renal Failure and I would like to share my experience with Others!! I would also like others to share their stories with me. Let's share our experiences of Renal Failure. Have you had your ups and downs? Are you able to work? Are you able to travel? Which dialysis do you do? Have you had your transplant yet?

Let me share a little about myself. My name is Lorrie and I am in Renal Failure. I knew about my diagnosis as a teen. I never really took my diagnosis seriously which means I never took care of myself the way I should. Sept of 2011, I was finally told that my kidneys are on their last leg and it is time for Dialysis (UGH) 2011 was a horrible year. I was sick, had numerous operations due to my kidneys. Such as parathyroid surgery. a site made for my dialysis (fistula) done three times and the list goes on. I am now on a transplant list (UNOS) with UC DAVIS and in Hopes of being putting on with San Francisco.

I do Hemo dialysis 4 days a week with 3 days off. I use the buttonhole technique which at times really hurts me. My machine used is the NX stage. I do my dialysis at home with my Husband being my caregiver.

So come and share your story and lets become friends and support each other through this process. I will write you each day to let you know how my day is going. Look forward to hearing you!

5 Stages of Renal Faillure

*GFR is glomerular filtration rate, a measure of the kidney's function.

These numbers are very important numbers that you need to watch for.

Stage 1 Slight kidney damage with normal or increased filtration More than 90 (GFR)

Stage 2 Mild decrease in kidney function 60-89 (GFR)

Stage 3 Moderate decrease in kidney function 30-59 (GFR)

Stage 4 Severe decrease in kidney function 15-29 (GFR)

Stage 5 Kidney failure Less than 15 (GFR) (or dialysis)

The lowest mine got down to was a 10. I then had to start Dyalisis

Different Types of Dialysis

Renal Failure

So what are the different types of Dialysis once in Renal Failure?

Peritoneal Dialysis (PD)

Dialysis is a treatment for kidney failure. It helps replace the work of the kidneys when they have stopped working. Peritoneal dialysis (also called PD) is a type of dialysis.

What is PD?

PD is a way of cleaning waste and extra fluid from your blood. PD uses a special fluid called dialysate and the lining of your belly to do this.

The organs in your belly are inside a special lining called the peritoneum. This natural lining is thin and acts like a filter. It lets some things through and keeps others out.

For PD, you will have a soft flexible tube (called a catheter) that goes from outside your body to inside your peritoneum. This catheter is placed during a minor surgery. Then, you will:

Put dialysate fluid into your belly through your catheter

Let the dialysate sit in your belly for several hours

During this time, the dialysate fluid pulls waste and extra fluid out of your blood. This is called the “dwell time.”

Drain the dialysate, along with the waste and extra fluid, out through your catheter

Put new dialysate fluid into your belly and repeat the process

This process is called an exchange. Your doctor will tell you how many exchanges to do each day. Your doctor will also tell you what kind of dialysate to use.

Where can I do PD treatments?

PD treatments are usually done at home in a clean, dry place. Because PD is fairly portable, you may also do it while traveling. This makes it a more flexible treatment option.

While you do not need to go to a dialysis center for your treatments, you will still need to work with a center to learn how to do your PD exchanges and to get your supplies.

How can I stay healthy on PD?

One of the most common problems with PD is the risk of peritonitis. This is when your peritoneum, that natural lining in your belly, gets infected. This might happen if germs get into your belly through your catheter.

Bad infections can keep you from being able to do the PD treatments you need. To help prevent an infection:

Learn the right way to do your exchanges

The staff at your dialysis center can help. Don’t be afraid to ask questions.

Keep all of your PD supplies in a clean, dry place

Do all of your exchanges in a clean, dry place

Always wash your hands before doing an exchange

Wear a surgical mask when you do exchanges

If you think you do have an infection, get treatment quickly. Tell your doctor right away if:

You see pink or red around your catheter

You have pain around your catheter

Your catheter shifts or starts to come out

Any of the clamps on your catheter break

Your dialysate looks cloudy

You have a fever

You feel very sick or throw up

Part 2 on Different kinds of Dialysis

Renal Failure

In hemodialysis, your blood is allowed to flow, a few ounces at a time, through a special filter that removes wastes and extra fluids. The clean blood is then returned to your body. Removing the harmful wastes and extra salt and fluids helps control your blood pressure and keep the proper balance of chemicals like potassium and sodium in your body.

One of the biggest adjustments you must make when you start hemodialysis treatments is following a strict schedule. Most patients go to a clinic-a dialysis center-three times a week for 3 to 5 or more hours each visit. For example, you may be on a Monday-Wednesday-Friday schedule or a Tuesday-Thursday-Saturday schedule. You may be asked to choose a morning, afternoon, or evening shift, depending on availability and capacity at the dialysis unit. Your dialysis center will explain your options for scheduling regular treatments.

Researchers are exploring whether shorter daily sessions, or longer sessions performed overnight while the patient sleeps, are more effective in removing wastes. Newer dialysis machines make these alternatives more practical with home dialysis. But the Federal Government has not yet established a policy to pay for more than three hemodialysis sessions a week.

Several centers around the country teach people how to perform their own hemodialysis treatments at home. A family member or friend who will be your helper must also take the training, which usually takes at least 4 to 6 weeks. Home dialysis gives you more flexibility in your dialysis schedule. With home hemodialysis, the time for each session and the number of sessions per week may vary, but you must maintain a regular schedule by giving yourself dialysis treatments as often as you would receive them in a dialysis unit.

Adjusting to Changes

Even in the best situations, adjusting to the effects of kidney failure and the time you spend on dialysis can be difficult. Aside from the "lost time," you may have less energy. You may need to make changes in your work or home life, giving up some activities and responsibilities. Keeping the same schedule you kept when your kidneys were working can be very difficult now that your kidneys have failed. Accepting this new reality can be very hard on you and your family. A counselor or social worker can answer your questions and help you cope.

Many patients feel depressed when starting dialysis, or after several months of treatment. If you feel depressed, you should talk with your social worker, nurse, or doctor because this is a common problem that can often be treated effectively.

Getting Your Vascular Access Ready

Arteriovenous fistula. One important step before starting hemodialysis is preparing a vascular access, a site on your body from which your blood is removed and returned. A vascular access should be prepared weeks or months before you start dialysis. It will allow easier and more efficient removal and replacement of your blood with fewer complications

Equipment and Procedures

When you first visit a hemodialysis center, it may seem like a complicated mix of machines and people. But once you learn how the procedure works and become familiar with the equipment, you'll be more comfortable.

Dialysis Machine

The dialysis machine is about the size of a dishwasher. This machine has three main jobs:

pump blood and watch flow for safety

clean wastes from blood

watch your blood pressure and the rate of fluid removal from your body


Structure of a typical hollow fiber dialyzer. The dialyzer is a large canister containing thousands of small fibers through which your blood is passed. Dialysis solution, the cleansing fluid, is pumped around these fibers. The fibers allow wastes and extra fluids to pass from your blood into the solution, which carries them away. The dialyzer is sometimes called an artificial kidney.

Reuse. Your dialysis center may use the same dialyzer more than once for your treatments. Reuse is considered safe as long as the dialyzer is cleaned before each use. The dialyzer is tested each time to make sure it's still working, and it should never be used for anyone but you. Before each session, you should be sure that the dialyzer is labeled with your name and check to see that it has been cleaned, disinfected, and tested

Dialysis Solution

Dialysis solution, also known as dialysate, is the fluid in the dialyzer that helps remove wastes and extra fluid from your blood. It contains chemicals that make it act like a sponge. Your doctor will give you a specific dialysis solution for your treatments. This formula can be adjusted based on how well you handle the treatments and on your blood tests.


Many people find the needle sticks to be one of the hardest parts of hemodialysis treatments. Most people, however, report getting used to them after a few sessions. If you find the needle insertion painful, an anesthetic cream or spray can be applied to the skin. The cream or spray will numb your skin briefly so you won't feel the needle.

Most dialysis centers use two needles-one to carry blood to the dialyzer and one to return the cleaned blood to your body. Some specialized needles are designed with two openings for two-way flow of blood, but these needles are less efficient and require longer sessions. Needles for high-flux or high-efficiency dialysis need to be a little larger than those used with regular dialyzers.

Some people prefer to insert their own needles. You'll need training on inserting needles properly to prevent infection and protect your vascular access. You may also learn a "ladder" strategy for needle placement in which you "climb" up the entire length of the access session by session so that you don't weaken an area with a grouping of needle sticks. A different approach is the "buttonhole" strategy in which you use a limited number of sites but insert the needle back into the same hole made by the previous needle stick. Whether you insert your own needles or not, you should know these techniques to better care for your access.

Tests to See How Well Your Dialysis Is Working

About once a month, your dialysis care team will test your blood by using one of two formulas-URR or Kt/V-to see whether your treatments are removing enough wastes. Both tests look at one specific waste product, called blood urea nitrogen (BUN), as an indicator for the overall level of waste products in your system.


Focusing on Faith

Making Health a Priority

For those of Faith, You may find this to be useful.

The National Kidney Disease Education Program is partnering with the American Diabetes Association (ADA), National Coalition of Pastors’ Spouses (NCPS) and Chi Eta Phi national nursing sorority to recognize National Kidney Month in March 2012.

Faith organizations from around the country will conduct Kidney Sundays events on March 25, educating their congregations about the importance of kidney health. They will include health screenings, provided by Chi Eta Phi nurses, for their members, testing for high blood pressure, obesity and diabetes. Congregations also will recognize Diabetes Alert Day on March 27 and discuss the connection diabetes has to kidney disease.

NCPS president Vivian Berryhill, of New Philadelphia Baptist Church in Memphis, Tenn., explains why a national kidney health event is important and talks about what other faith organizations can do to help their congregants stay healthier longer.

What is the National Coalition of Pastors’ Spouses?

The National Coalition of Pastors’ Spouses, (NCPS) is a nonprofit, non-partisan multi-denominational network of 2,500+ clergy spouses, committed to raising awareness and addressing health disparities across this nation... using faith groups as health hubs.

Why is health education and outreach such an important concern for your organization’s members?

NCPS was formed in January 2001 for one main purpose and one common mission: addressing the spiritual and physical wellness of those in our churches, communities, and neighborhoods. For the past 11 years, we have focused on tackling health care issues and concerns which disproportionately impact communities of color by providing useful information aimed at prevention, education, training, awareness and life-style changes. African Americans rank highest in diabetes, heart disease, high blood pressure and other debilitating diseases. Therefore, pastors' spouses, as servant leaders, are committed to helping stem further proliferation of these diseases within our ranks and within our communities.

Why is NCPS joining with NKDEP, the American Diabetes Association, and Chi Eta Phi to conduct the first national Kidney Sundays event?

NCPS recognizes the African-American church as the bedrock institution in most communities across this nation. Pastors' spouses know that any awareness campaign, be it health, education, political, or civic in nature––whose aim is to reach the masses at the grassroots level––must emanate in the faith community. With that being said, NCPS is honored to serve as one of the charter partners for the national Kidney Sunday effort. It's a natural fit for NCPS to work with our national kidney partners during National Kidney Month to get this valuable information to those we love.

Do you think that faith members are aware that diabetes and high blood pressure are the 2 leading risk factors for kidney disease?

I think we still have lots of work ahead of us in terms of educating people on the serious effects of diabetes, obesity, high blood pressure, and eating habits, and how each relate to kidney health. Efforts such as Kidney Sundays are a great start to help pastors' spouses get the conversations started. This faith-focused kidney awareness campaign gives churches an opportunity to post on church bulletin boards, to disseminate via church bulletins, and to preach from the pulpit about information in a forum where we know people trust us and will pay attention.

Does your congregation offer any other health education and awareness activities to members? If yes, what types?

My husband, Pastor Chester L. Berryhill Jr., who was diagnosed with pre-diabetes several years ago, has implemented culinary change within our local church in Memphis. Our meals now feature baked foods, salads, greens and beans without the customary fatback. Two or three times per year we have what is known as "salad and soup Sunday." He is not the only pastor who, because of health reasons, has geared his church on a healthy eating course. This is a trend that I anticipate will spread exponentially over the next few years.

Writer Chronicles Kidney transplant in book

A brother could not give his brother a Kidney transplant. The least he could do was read his book (Another second chance). Check out the Article below. Written by

Vince Guerrieri

Staff writer

FREMONT — Toby Lewis couldn’t give his brother Troy a kidney.

The least he could do was read Troy’s book.

Toby and his son Luke were among the throng of fans and well-wishers Saturday at DaVinci’s on Front Street as Troy Lewis met people and signed copies of his new book, “Another Second Chance,” about his odyssey through kidney disease and a transplant.

Spoiler alert: Troy survives, and thrives. But there’s no happy ending — because the story’s not over yet.

“I’m doing fantastic,” he said. “God’s giving me another shot at life, so I better do something about it.”

Troy has IgA nephropathy, a disorder where an excess of IgA — a protein made by the body to fight illnesses — settles in the kidneys. In about 80 percent of the cases, people lead normal lives, some probably not even knowing they have the disease.

Troy was one of the 20 percent. His kidneys started to fail about three years ago, and he started taking prednisone, a steroid, to counteract it. He ended up taking dialysis — a medical procedure where machines perform some of the function of the kidneys, removing waste and excess fluid from the blood.

He needed a kidney transplant. And it was going to be difficult.

“Most people can get kidneys from their brother,” he said. “I have four brothers and they couldn’t help me.”

“I wanted to,” Toby said. “They wouldn’t let me.”

The elders at Fremont Alliance Church prayed over Troy a couple times, and when his brothers weren’t able to find a matching kidney, people from the church took it upon themselves to start getting tested to see if they were a match.

“After three weeks, UTMC (University of Toledo Medical Center) called and told us, ‘Stop sending people,’” Troy said. “We said we didn’t send anyone.”

Troy’s health became a race against the clock, as his blood pressure continued to climb and he continued to receive dialysis.

“It became, ‘Was he going to get the kidney in time or would he have a stroke and die?’” Troy said.

More than 1,000 miles away, a pastor in Colorado Springs was a match.

“He said he walked into a hospital and said he wanted to give a kidney because God moved him to,” said Troy, who had previously played Jesus in the annual passion play at Fremont Alliance Church.

Through the Alliance for Paired Donation, Troy received a kidney from Jay Julian, the donor in Colorado. In exchange, Troy’s brother Tony, also a minister, agreed to donate a kidney. That also became an adventure.

Tony went through a chest catheter and a colonoscopy to make sure he was healthy enough to donate. While on the operating table, it was discovered he had an aneurysm, a thinning of the arterial wall in a blood vessel. The aneurysm burst on the operating table.

Doctors worked feverishly, and not only did Tony survive the operation and the aneurysm, he was able to donate the kidney to a recipient in Florida.

On July 28, 2010, Troy got the kidney he needed. Within two months, he was back to work at Shambaugh and Son Fire Protection in Perrysburg. And he was telling his story — and it wasn’t long before people started telling him he should write a book about it.

“I don’t write books,” said Troy, a slacker in high school by his own admission. “I’m a construction worker.”

“Before he wrote one,” said his wife Stephanie, “he didn’t even read books.”

Writing the book was an ordeal for him — although nowhere near as much an ordeal as living the story he was struggling to tell. On three separate occasions, he thought about quitting the project. But it got written and reviewed by those around him.

“I think I was more truthful than he wanted me to be,” Stephanie said. “I have to keep him in line.”

Gus Lawson, Troy’s neighbor, also read the first couple chapters, and he found the copy to be mostly clean.

“We didn’t really have to do anything with it,” he said.

In December, Troy received copies of his book, published by Writing Career Coach Press, and had that moment of triumph that hits anyone who’s ever seen their name in print. Now, he’s trying to sell it.

Zeke Villarreal stopped by to see Troy at the book signing Saturday. Villarreal coached Troy’s daughters in softball. Prior to his surgery, Troy was also a softball coach, for the Fremont Crimson Giants.

Villarreal is already halfway through the book, reading it during lunch breaks at work. Some of the events are familiar to him, but the book is more than that.

“Even if you’re part of their life, the book gives you more information,” he said.

Toby said it might have been the first book he’s read since he graduated high school.

And Stephanie just stood there at DaVinci’s and beamed. After watching her husband go through everything, it was a genuine thrill to see him ebullient and active again.

“When you say your vows, it’s for better or for worse,” she said. “And that was worse.

“Now it’s better.”




Purchase Image

Troy Lewis signs a copy of his book, “Another Second Chance,” Saturday for Julie Guth of Bettsville at DaVinci’s in Fremont. / Vince Guerrieri/News-Messenger

Written by

Vince Guerrieri

Staff writer



Local News

University Of Toledo Medical Center

‘Another Second Chance’

Troy Lewis’ book “Another

Second Chance” is available for sale at Thingamajig and

Anchored to the Rock in

Fremont, J&R Gospel Gift Shop and Holy Family Book Store in Sandusky and Bookshelf Two in Fostoria. It’s also available

online at www.Another Lewis will have a book signing at Anchored to the Rock on Feb. 11.

Study identifies new biomarkers for kidney failure in diabetes patients

article written 1/20/2012

I thought this was a good article and interesting. Thought you would like it too.

Scientists at Joslin Diabetes Center have identified two novel markers that, when elevated in the blood stream, can predict accurately the risk of kidney failure in patients with Type 1 and Type 2 diabetes. The findings have immediate diagnostic implications and can be used for the development of new therapies to prevent or postpone the progression of renal disease in diabetes, the authors said.

In two studies published in the Journal of the American Society of Nephrology, the Joslin researchers found that high concentrations of Tumor Necrosis Factor Receptor 1 and 2 (TNFR1 and TNFR2) accurately predict the risk of renal function loss in Type 1 and in Type 2 diabetes ten years in advance. Currently available clinical tests cannot identify people at risk with that level of precision.

"These markers are excellent predictors of early and late renal function decline in patients with diabetes," said senior author Andrzej Krolewski, MD, PhD, section head of Genetics and Epidemiology at Joslin.", Our findings may improve clinical care for patients who are at risk of kidney damage."

In one study, Krolewski and his colleagues followed 410 patients with Type 2 diabetes for eight to 12 years and found that those at risk of ESRD had elevated concentrations of TNFR1 and TNFR2 in their blood. That prompted them to investigate whether circulating TNFR1 and TNFR2 are also indicators of early renal function decline in Type 1 diabetes. Their subsequent study of 628 patients with Type 1 diabetes similarly found that those with high levels of TNFR1 and TNFR2 were at higher risk of early stages of renal function loss. Elevated levels of these protein receptors led to renal disease in diabetic patients, regardless of the presence or absence of other clinical characteristics that are considered important risk factors for diabetic nephropathy.

At the beginning of the studies, the researchers measured several dozen inflammatory markers in more than a thousand subjects with diabetes, monitored these individuals, and collected data on whether their renal function declined and, more importantly, if they developed renal failure and required dialysis or transplantation. The researchers discovered that the effect of TNFR1 and TNFR2 on renal function was distinct from other markers or clinical measurements, such as blood pressure, albuminuria, and glycated hemoglobin, which are currently evaluated in doctors' offices. The scientists do not know how or why TNF receptors contribute to the injury of the diabetic kidney, but preliminary data suggests that the effect of TNFR1 and TNFR2 expands beyond the simple effect of TNFα mediation

Study reports Tennessee collaborative improves quality of surgical care

Published on January 24, 2012

A new study published online today in the Journal of the American College of Surgeons finds hospitals participating in a regional collaborative of the American College of Surgeon's National Surgical Quality Improvement Program (ACS NSQIP-), achieved substantial improvements in surgical outcomes, such as reducing the rates of acute renal failure and surgical site infections. The collaborative also saved $2,197,543 per 10,000 general and vascular surgery cases when comparing results from 2010 with results from 2009. ACS NSQIP is the leading nationally validated, risk-adjusted, outcomes-based program to measure and improve the quality of surgical care in the private sector.

The Tennessee Surgical Quality Collaborative (TSQC) collected ACS NSQIP data from 10 participating hospitals to examine and identify trends in surgical outcomes and evaluate best practices among these hospitals. The study evaluated 20 categories of postoperative complications, 30-day mortality rates, and hospital costs associated with postoperative complications in a total of 14,205 surgical cases in 2009 and 14,901 surgical cases in 2010.

"We demonstrated that hospitals in a collaborative can greatly improve their quality by sharing data, comparing results, and evaluating best practices and process improvement approaches with their peers," said Joseph B. Cofer MD, FACS, statewide surgeon champion for the collaborative, author of the study and professor of surgery and surgery residency program director, Department of Surgery, at the University of Tennessee College of Medicine-Chattanooga.

The Tennessee collaborative saw improvements in such procedures as acute renal failure (25.1% reduction, P = 0.023), graft/prosthesis/flap failure (60.5% reduction, P < 0.0001), ventilator greater than 48 hours (14.7% reduction, P = 0.012), superficial site infection (18.9% reduction P = 0.0005), and wound disruption (34.3% reduction, P = 0.011), according to the researchers. These improvements led to a net savings of nearly $2.2 million per 10,000 general and vascular procedures, according to the study. As ACS NSQIP collects only a sample of cases done, the implications for total costs avoided are much greater. It is estimated that 10,000 cases represents only about one fourth of the total general and vascular surgery cases done in the TSQC hospitals in 2009 and 2010. If the ACS NSQIP methodology were applied to all cases, the total costs avoided might be more than $8 million when comparing the results from 2010 with those from 2009.

According to the researchers, improvements in areas such as skin and soft tissue/wound disruption and ventilator management may be credited to the identification of a problem and rapid change in practice based upon evidence-based medicine.1 Improvements in renal and graft failure may be attributed to overall attention being focused on a problem that was uncovered through involvement in ACS NSQIP.

"While previous studies have shown that participation in quality improvement programs such as ACS NSQIP have been shown to save lives, improve health and reduce costs, the Tennessee collaborative illustrates that participation in an ACS NSQIP collaborative can accelerate those benefits and take quality improvement to a whole new level," said Oscar D. Guillamondegui, MD, MPH, FACS, lead author and associate professor of surgery at Vanderbilt University Medical Center, Nashville.

It is great to see how things are improving throughout the years!

Renal Diet Secrets?

I’ve come across an exciting new solution for people searching for a healthy renal diet.

A registered nurse by the name Rachael Gordon recently completed her study on renal diets and wrote a tell-all report, called Kidney Diet Secrets.

According to Rachael, her controversial report is scientifically proven and recommended by top doctors to reverse renal disease without going through dialysis and/or kidney transplants…FOREVER?

Her report includes a sample of 1 week renal diet menu, 100 renal diet recipes, specific instructions for renal diabetic diet, it also comes with general renal diet guidelines for renal disease sufferers. She discusses renal diet foods, renal diet restrictions and renal diet foods to avoid depending on the stage of your condition.

Rachael has been helping renal disease sufferers for over 10 years and her experience with renal diets/kidney diet is extensive.

Do any of these symptoms sound familiar to you?

- Protein traces in the urine tests positive after a paper strip test.

- Fatigue or constant tiredness

- Muscle Cramps

- Loss of Appetite

- Nausea and Vomiting

- Getting easily bruised

- Dryness and Itching

- Difficulty breathing upon Exertion

If you have a renal disease, there is one important thing you need to know…

You are not alone…

Statistics show around 12 million Americans suffer from renal disease.

Here are a few sneak peeks of what’s inside Rachael’s controversial Renal Diet Report:

- How you can get rid of fatigue and muscle cramps with a simple strategy that takes just minutes to implement…

- Emergency techniques you must know. This should be included in each and every renal disease patients’ day to day activities at all times.

- How to use the power of a common item that you may have right now to treat some annoying symptoms of your renal disease.

- A forbidden secret technique to get rid of renal/kidney pains if you are experiencing it right now. You will be amazed how easy it is.

- How to manage diabetic renal disease. If you have diabetes, chances are you will have a different approach. It is all included inside.

- Losing weight while treating renal/kidney failure. If you do it the wrong way, far riskier consequences await you. It’s a must learn for each and every patient.

- How to control and avoid anemia. All too often renal patients are prone to having this condition, after learning the secret inside, it’s as good as impossible.

Be sure to check out Rachael’s Kidney Diet Secrets, and come back here to post your comments about it. I’d love to hear your feedback on her report.

Best of Luck,


Awak to Give Dialysis Patients Freedom

Portable Artificial Kidney Device Developed by Singapore Group Uses Less Fluid; Clinical Tests Are Upcoming

The millions of dialysis patients around the world may soon gain greater freedom and cost savings through a portable, wearable artificial kidney device developed by Singapore outfit Awak Technologies Pte. Ltd.

The product—currently undergoing animal and lab tests in Singapore and preparing for clinical trials in the U.S., Germany and Singapore—performs peritoneal dialysis using a small amount of liquid and has been named a finalist in the Asian Innovation Awards.

Gordon Ku, Awak's chairman, said he had been frustrated that in his 41 years as a nephrologist, or kidney doctor, dialysis treatment for end-stage renal disease saw no significant advancements.

"In the past 40 years the only development is that the machine has become half the size," Dr. Ku said. "It may be easier to operate. As far as the delivery of dialysis is concerned there are no major improvements."

The theory behind Awak came from Drs. David Lee and Martin Roberts at the VA Greater Los Angeles Healthcare System and the David Geffen School of Medicine at University of California, Los Angeles. Dr. Ku joined with them to found Awak in 2007. In the past four years, the device has morphed from a torso-sized vest to the size of a small purse.

Only about 7% of kidney patients use peritoneal dialysis, with the majority undergoing hemodialysis. But in Hong Kong, where the majority of patients use peritoneal dialysis, "we have proved that PD works very well," said Dr. Lo Wai Kei, honorary clinical associate professor in the University of Hong Kong's Department of Medicine. "It's more economical, and patients enjoy it." The city also lacks two factors necessary for hemodialysis clinics: nurses and space for equipment.

One of the drawbacks of home treatment is patients have to conduct interchanges themselves. Sometimes germs enter the body, leading to infection. Dr. Lo said some of the new trends in treatment are toward giving dialysis patients more freedom.

Hemodialysis cleanses the blood by running it through a machine and back into the body, while peritoneal dialysis works in the abdomen. "The sorbent in the process removes all the uremic toxins and all the electrolytes," Dr. Ku said. "That takes place in our device. We put back in the necessary electrolytes and glucose."

The company has conducted lab tests using spent dialysis fluid, running it through the wearable machine and testing it afterward. The findings show that the resulting fluid was cleansed of toxins.

Awak patients change the disposable cartridge in their device as many as three times a day. It contains 750 milliliters of fluid solution, compared with 8 to 10 liters a day required for traditional peritoneal dialysis machines, and 120 liters used for a four-hour hemodialysis session.

The fluid used will need to be changed no more than once a month, Dr. Ku said. By requiring so little dialysate, the expensive mix of water and chemicals used in dialysis, Awak hopes to reduce costs for patients, providers and treatment centers.

There are a couple other companies working on wearable hemodialysis machines in the U.S., but so far they have not reached the market. Awak believes its product will create a paradigm shift in treatment, forcing providers to change long-standing practices. Awak plans to price its product at or below the monthly reimbursement rate for patients in the U.S., currently $1,800. According to the 2010 annual report from U.S. Renal Data System, in 2008 there were almost 550,000 dialysis patients in the U.S. with a total cost of $39.5 billion.

A challenge for patients is that they experience inconsistent levels of chemicals and waste in the body between treatments, resulting in lack of control over blood pressure, anemia or phosphate retention. With a device like Awak, patients won't need the additional medications to treat these side effects. Dr. Lo of the University of Hong Kong said the trend toward continuous dialysis will help solve this problem. But the greatest benefit, according to Awak, is a change in lifestyle, allowing patients to travel freely and go back to work. Moreover, Dr. Ku said, doctors will be able to tailor the treatment using different strengths of cartridges for larger people, or more active people.

Now, Awak is preparing for certification in the U.S. and Europe simultaneously.

In collaboration with Temasek Polytechnic, Awak is hoping to submit clinical data to regulatory bodies in the U.S. and Europe by 2013. The institute has been instrumental to Awak's research, development and business plan. The Awak team is currently setting up a kidney-research institute in Singapore, and future plans include making a waterproof version.

Write to Emily Veach at

Has Anybody Here, Seen my Old Friend Allient? Can you Tell me Where he's Gone?

By Peter Laird, MD

In June of 2006, Renal Solutions achieved FDA approval of their new sorbent dialysis machine that uses potable tap water to generate dialysate. The REDY system came out of the NASA space program that regenerated potable drinking water from the astronauts urine. Clinical applications of this process resulted in the REDY system which many early dialysis patients used successfully for temporary travel. Renal Solutions redeveloped this process with new and updated technology ready for the market by the end of 2005. However, we are still waiting the first patient use of this new technology today.

Renal Solutions Ready for Commercial Sales

August 9, 2005

With preliminary FDA approval in hand, the Pittsburgh Business Times reports that Renal Solutions is set to receive the first of its portable kidney dialysis system this week to begin testing to ensure they were built to the company's specifications. Insitutional sales to nursing homes and hospitals will begin over the next several months. Sales to the home user market will wait until further trials are run and final FDA approval is granted. The Company expects final approval for sale to home users early in 2006.

Xcorporeal developed another sorbent based innovative dialysis machine that expected to market their product by 2009 opening the door to even more patients having access to home hemodialysis. Now, in 2012, neither Renal Solutions or Xcorporeal have been seen by any home dialysis patients to date.

New Machine Makes Home-Based Dialysis a Reality for Millions of Patients Worldwide

LOS ANGELES--(BUSINESS WIRE)--Xcorporeal, Inc. (AMEX:XCR) announced today the XCR-6 Dialysis Platform for self-directed kidney hemodialysis. The XCR-6 will be the smallest, lightest, and easiest to use dialysis machine ever conceived, using Xcorporeal’s proprietary closed loop, regenerated dialysate technology platform. The Company is currently preparing for unattended/home use clinical trials of the XCR-6 in anticipation of commercialization in the near future.

Xcorporeal's Wearable Artificial Kidney Prototype Device Featured in Los Angeles Times Article

For the RRT market, Xcorporeal is developing a portable, multifunctional renal replacement device that will offer cost effective therapy for those patients suffering from Acute Renal Failure (ARF) which causes a rapid decline in kidney function. In the U.S., the disease affects more than 200,000 patients annually, with a mortality rate of 50%. The Xcorporeal platform technology is a natural fit for the hospital market of renal replacement therapy since the technology is designed to provide cost-effective, continuous therapy without the need for expensive replacement fluids. The projected 2007 market opportunity for the U.S. is approximately $1.4 billion. The disposable market is expected to grow at 10% per year. The devices typically need to be replaced every five years. The Company intends to commercialize this device during the first half of 2009.

Where have these machines all gone? The answer is apparent when we realize that a corporate giant bought both of these companies several years ago with the alleged hope that the infusion of capital would promote more rapid development of this new technology, yet today, we are still waiting for any sign of progress. The corporation now holding the patents to these innovative machines is Fresenius Medical Care, the largest manufacturer of dialysis machines in the world.

Fresenius Medical Care acquire techology to advance home hemodialysis and create a platform for development of a wearable kidney

Dr. Ben Lipps, Chief Executive Officer of Fresenius Medical Care commented, “The acquisition of RSI is an important step to advance the technology required for strong future growth in this field. The combination offers us the long-term opportunity to extend our leadership to home and acute dialysis products. Furthermore, by combining our equipment and membrane technology with the SORB technology, we can provide innovative solutions in the future such as a possible wearable kidney. With this acquisition, Fresenius Medical Care expects to increase its annual R&D spending by approximately $10 million starting in 2008. Our mid-term financial targets for the years 2007 through 2010 remain unchanged.”

Fresenius Buys Xcorporeal for $8 million

LOS ANGELES—Fresenius has agreed to purchase Xcorporeal Inc., which is developing a wearable artificial kidney, for $8 million.

Xcorporeal is a medical device company developing an extra-corporeal platform technology to be used in devices to replace the function of various human organs. The platform includes three initial products: a Portable Artificial Kidney (PAK) for hospital-based renal replacement therapy, the XCR-6 for home hemodialysis, and a Wearable Artificial Kidney (WAK) for continuous ambulatory hemodialysis.

Month after month, year after year, the machines that had FDA approval for clinical use in 2006 still continue in shrouded mystery as to when they will actually be released. Several experts state that the technology is an improvement and a solution to many in need of home dialysis options here in the US and around the world. The fruits of the NASA space program lie dormant to date for the hope of the future of dialysis hidden within the confines of the secretive bureaucracy of the largest dialysis organization in America. The jury is still out on whether FMC bought these companies to expand home dialysis options or instead to stifle competition with their own dialysis oligarchy. The only proof of the former will be the actual release of sorbent technology for clinical testing and rapid penetration of the home dialysis market. Until then, all we can ask is where have they gone for we know that the good, they die young.

Dialysis Patients Unprepared for Disasters

Source: American Society of Nephrology (ASN)

Newswise — Washington, DC (August 19, 2011) — Most dialysis patients are not prepared to effectively handle man-made or natural disasters, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN). This puts them in great danger of becoming seriously sick or dying in the face of a disaster.

Patients on dialysis depend on technology to keep them alive. But what happens when a disaster—such as the recent tornadoes in the Midwest or the earthquake in Japan—strikes? Disaster scenarios fall along two lines of response. During tornadoes or hurricanes, people must evacuate their homes and seek shelter in other locations. In these situations, dialysis patients should know where alternative dialysis clinics are, have medications on hand, and carry medical documentation of their kidney condition, among other precautions. Other events such as severe ice or snow storms require people to stay in their homes. In these situations, dialysis patients should be careful how much they drink, have a stockpile of appropriate foods and medications, and notify local police, fire, electric, water, and emergency services.

Mark Foster, Jane Brice, MD, Maria Ferris, MD, PhD (University of North Carolina School of Medicine) and their colleagues surveyed 311 patients who received care at various dialysis centers in central North Carolina.

Among the major findings:

•All dialysis centers had a disaster preparedness program in place, but most patients were not well-prepared for a disaster.

•Only 43% of patients knew of alternative dialysis centers.

•Only 42% had adequate medical records at home that they could take with them in short notice.

•Only 40% had discussed the possibility of staying with a friend or relative during a disaster.

•Only 15% had a medical bracelet or necklace they could wear if they were forced to leave their homes.

•Age, gender, race, education, literacy, and income did not affect disaster preparedness.

Results were slightly better when patients were asked about their preparations for disasters that would force them to stay in their homes. Fifty-seven percent knew what diet they should follow during a disaster, and 63% had a two-week supply of extra medications.

These findings are disturbing: disruptions in care for dialysis patients can seriously jeopardize their health. “A dialysis patient relies on frequent visits to a dialysis facility to maintain his or her health, and when patients cannot receive dialysis due to lack of clean water, lack of electricity, impassable roadways, etc., severe medical complications can occur quite quickly,” said Foster. “This lack of preparation should stimulate measures to ensure better preparation for future disasters.”

The results indicate that dialysis centers and medical organizations should work harder to educate and help dialysis patients prepare themselves for a potential disaster.

Study co-authors include Frances Shofer, PhD, Darren Dewalt, MD, Ronald Falk, MD (University of North Carolina), and Stephanie Principe (Davidson University).

Disclosures: The authors reported no financial disclosures.

The article, entitled “Personal Disaster Preparedness of Dialysis Patients in North Carolina,” will appear online at doi 10.2215/CJN.03590411

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, and with more than 12,000 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

Top 15 Healthy Foods for People with Kidney Disease

Researchers are discovering more and more links between chronic diseases, inflammation and “super foods” that may prevent or protect against undesirable fatty acid oxidation, a condition that occurs when the oxygen in your body reacts with fats in your blood and your cells. Oxidation is a normal process for energy production and many chemical reactions in the body, but excessive oxidation of fats and cholesterol creates molecules known as free radicals that can damage your proteins, cell membranes and genes. Heart disease, cancer, Alzheimer’s disease, Parkinson’s disease and other chronic and degenerative conditions have been linked to oxidative damage.

However, foods that contain antioxidants can help neutralize free radicals and protect the body. Many of the foods that protect against oxidation are included in the kidney diet and make excellent choices for dialysis patients or people with chronic kidney disease (CKD). Eating healthy foods, working with a renal dietitian and following a renal diet made up of kidney-friendly foods is important for people with kidney disease because they experience more inflammation and have a higher risk for cardiovascular disease.

Here are the top 15 kidney-friendly foods with antioxidants that you may want to include in your healthy kidney diet.

1. Red bell peppers

1/2 cup serving red bell pepper = 1 mg sodium, 88 mg potassium, 10 mg phosphorus

Red bell peppers are low in potassium and high in flavor, but that’s not the only reason they’re perfect for the renal diet. These tasty vegetables are also an excellent source of vitamin C and vitamin A, as well as vitamin B6, folic acid and fiber. Red bell peppers are good for you because they contain lycopene, an antioxidant that protects against certain cancers.

To include red bell peppers in the kidney diet, eat them raw with dip as a snack or appetizer, or mix them into tuna or chicken salad and serve on crackers or bread. You can also roast peppers and use them as a topping on sandwiches or lettuce salads, chop them for an omelet, add them to kabobs on the grill or stuff peppers with ground turkey or beef and bake them for a main dish.

2. Cabbage

1/2 cup serving green cabbage = 6 mg sodium, 60 mg potassium, 9 mg phosphorus

A cruciferous vegetable, cabbage is packed full of phytochemicals, chemical compounds in fruit or vegetables that break up free radicals before they can do damage. Many phytochemicals are also known to protect against and fight cancer, as well as foster cardiovascular health. Sulforaphane, a phytochemical in cruciferous vegetables, may prevent or stop cancer cell growth in lung, colon, breast, bladder, prostate and ovarian cancers.

High in vitamin K, vitamin C and fiber, cabbage is also a good source of vitamin B6 and folic acid. Low in potassium and low in cost, it’s an affordable addition to the kidney diet.

Raw cabbage makes a great addition to the dialysis diet as coleslaw or topping for fish tacos. You can steam, microwave or boil it, add butter or cream cheese plus pepper or caraway seeds and serve it as a side dish. Cabbage Rolls made with Turkey are a great appetizer, and if you’re feeling fancy, you can stuff a cabbage with ground meat and bake it for a flavorful meal bursting with nutrients.

3. Cauliflower

1/2 cup serving boiled cauliflower = 9 mg sodium, 88 mg potassium, 20 mg phosphorus

Another cruciferous vegetable, cauliflower is high in vitamin C and a good source of folate and fiber. It’s also packed full of indoles, glucosinolates and thiocyanates — compounds that help the liver neutralize toxic substances that could damage cell membranes and DNA.

Serve it raw as crudités with dip, add it to a salad or steam or boil it and season with spices such as turmeric, curry powder, pepper and herb seasonings. You can also make a nondairy white sauce, pour it over the cauliflower and bake until tender. You can pair cauliflower with pasta or even mash cauliflower as a dialysis diet replacement for mashed potatoes.

4. Garlic

1 clove garlic = 1 mg sodium, 12 mg potassium, 4 mg phosphorus

Garlic helps prevent plaque from forming on your teeth, lowers cholesterol and reduces inflammation.

Buy it fresh, bottled, minced or powdered, and add it to meat, vegetable or pasta dishes. You can also roast a head of garlic and spread on bread. Garlic provides a delicious flavor and garlic powder is a great substitute for garlic salt in the dialysis diet.

5. Onions

1/2 cup serving onion = 3 mg sodium, 116 mg potassium, 3 mg phosphorus

Onion, a member of the Allium family and a basic flavoring in many cooked dishes, contains sulfur compounds which give it its pungent smell. But in addition to making you cry, onions are also rich in flavonoids, especially quercetin, a powerful antioxidant that works to reduce heart disease and protects against many cancers. Onions are low in potassium and a good source of chromium, a mineral that helps with carbohydrate, fat and protein metabolism.

For people on a kidney diet looking to add more flavors to foods, try using a variety of onions including white, brown, red and others. Eat onions raw on burgers, sandwiches and in salads, cook them and use as a caramelized topping or fry them into onion rings. Include onions in recipes such as Italian Beef with Peppers and Onions.

6. Apples

1 medium apple with skin = 0 sodium, 158 mg potassium, 10 mg phosphorus

Apples have been known to reduce cholesterol, prevent constipation, protect against heart disease and reduce the risk of cancer. High in fiber and anti-inflammatory compounds, an apple a day may really keep the doctor away. Good news for people with kidney disease who already have their share of doctor visits.

This renal diet winner can be paired with the previous good-for-you food, onions, to make a unique Apple Onion Omelet. With versatile apples you can eat them raw, make baked apples, stew apples, make them into applesauce, or use in a dessert such as apple pie or apple cake. You can also drink them as apple juice or apple cider.

7. Cranberries

1/2 cup serving cranberry juice cocktail = 3 mg sodium, 22 mg potassium, 3 mg phosphorus

1/4 cup serving cranberry sauce = 35 mg sodium, 17 mg potassium, 6 mg phosphorus

1/2 cup serving dried cranberries = 2 mg sodium, 24 mg potassium and 5 mg phosphorus

These tangy, tasty berries are known to protect against bladder infections by preventing bacteria from sticking to the bladder wall. In a similar way, cranberries also protect the stomach from ulcer-causing bacteria and protect the lining of the gastrointestinal (GI) tract, promoting GI health. Cranberries have also been shown to protect against cancer and heart disease.

Cranberry juice and cranberry sauce are the most frequently consumed cranberry products. You can also add dried cranberries to salads or have them as a snack.

8. Blueberries

1/2 cup serving fresh blueberries = 4 mg sodium, 65 mg potassium, 7 mg phosphorus

Blueberries are high in antioxidant phytonutrients called anthocyanidins, which give them their blue color, and they are bursting with natural compounds that reduce inflammation. Blueberries are a good source of vitamin C; manganese, a compound that keeps your bones healthy; and fiber, and may also help protect the brain from some of the effects of aging. Antioxidants in blueberries and other berries have been shown to help slow bone breakdown in rats made to be low in estrogen.

Buy blueberries fresh, frozen or dried, and try them in cereal, topped with whipped topping, in a fruit smoothie or bake blueberry muffins, blueberry cake as blueberry crisp or blueberry pie. You can also drink blueberry juice.

9. Raspberries

1/2 cup serving raspberries = 0 mg sodium, 93 mg potassium, 7 mg phosphorus

Raspberries contain a phytonutrient called ellagic acid which helps neutralize free radicals in the body to prevent cell damage. They also contain flavonoids called anthocyanins, antioxidants which give them their red color. An excellent source of manganese, vitamin C, fiber and folate, a B vitamin, raspberries may have properties that inhibit cancer cell growth and tumor formation.

Add raspberries to cereal, puree and sweeten them to make a dessert sauce or add them to vinaigrette dressing. You can also drink raspberry punch.

10. Strawberries

1/2 cup serving (5 medium) fresh strawberries = 1 mg sodium, 120 mg potassium, 13 mg phosphorus

Strawberries are rich in two types of phenols: anthocyanins and ellagitannins. Anthocyananins are what give strawberries their red color and are powerful antioxidants that help protect body cell structures and prevent oxidative damage. Strawberries are an excellent source of vitamin C and manganese and a very good source of fiber. They are known to provide heart protection, as well as anti-cancer and anti-inflammatory components.

Eat strawberries with cereal, smoothies or salad, slice and serve them fresh or top them with whipped topping. If you’d like a more elaborate dessert, you can make strawberry pudding or sorbet or puree and sweeten them to serve as a dessert topping with angel food or pound cake. They also come in liquid form as strawberry nectar.

11. Cherries

1/2 cup serving fresh sweet cherries = 0 mg sodium, 160 mg potassium, 15 mg phosphorus

Cherries have been shown to reduce inflammation when eaten daily. They are also packed with antioxidants and phytochemicals that protect the heart.

Eat fresh cherries as a snack, make a cherry pie, cherry coffee cake, cherry crisp or cherry cheesecake. Cherry sauce can be tasty served with lamb or pork and you can drink a glass of cherry juice.

Continue: Top 15 Healthy Foods for People with Kidney Disease

12. Red grapes

1/2 cup serving red grapes = 1 mg sodium, 88 mg potassium, 4 mg phosphorus

Red grapes contain several flavonoids that give them their reddish color. Flavonoids help protect against heart disease by preventing oxidation and reducing the formation of blood clots. Resveratrol, a flavonoid found in grapes, may also stimulate production of nitric oxide which helps relax muscle cells in the blood vessels to increase blood flow. These flavonoids also provide protection against cancer and prevent inflammation. Phytochemicals in grapes, wine and grape juice have been extensively studied since the discovery that the French have much lower rates of heart disease despite a diet high in saturated fat.

Buy grapes with red or purple skin since their anthocyanin content is higher. Freeze them to eat as a snack or to quench thirst for those on a fluid restriction for the dialysis diet. Add grapes to a fruit salad or chicken salad. Try a unique kidney diet recipe for Turkey Kabobs that feature grapes. You can also drink them as grape juice or grape punch.

13. Egg whites

2 egg whites = 7 grams protein, 110 mg sodium, 108 mg potassium, 10 mg phosphorus

Egg whites are pure protein and provide the highest quality of protein with all the essential amino acids. For the kidney diet, egg whites provide protein with less phosphorus than other protein sources such as egg yolk or meats.

Buy powdered, fresh or pasteurized egg whites. Make an omelet or egg white sandwich, add pasteurized egg whites to smoothies or shakes, make deviled egg snacks or add whites of hard boiled eggs to tuna salad or garden salad to add extra protein.

14. Fish

3 ounces wild salmon = 50 mg sodium, 368 mg potassium, 274 mg phosphorus

Fish provides high-quality protein and contains anti-inflammatory fats called omega-3s. The healthy fats in fish help fight diseases such as heart disease and cancer. Omega-3s also help lower low-density lipoprotein or LDL cholesterol, which is bad cholesterol, and raise high-density lipoprotein or HDL cholesterol, which is good cholesterol.

The American Heart Association and American Diabetes Association recommend eating fish two or three times a week. Fish highest in omega-3s include albacore tuna, herring, mackerel, rainbow trout and salmon.

15. Olive oil

1 tablespoon olive oil = less than 1 mg sodium, less than 1 mg potassium, 0 mg phosphorus

Olive oil is a great source of oleic acid, an anti-inflammatory fatty acid. The monounsaturated fat in olive oil protects against oxidation. Olive oil is rich in ployphenols and antioxidant compounds that prevent inflammation and oxidation.

Parents, hospital meet about transplant for Amelia Rivera

By Kim Painter, USA TODAY

Here was a story that had really put a burst to my bubble. I was on the rampage for the next week. Here we have a blessed child who is mentally slow ( I like to put it) and was denied a Kidney due to her illness. Read the article below.

The parents of Amelia Rivera -- a disabled three-old girl whose cause has been taken up by thousands of online supporters -- have met again with a Philadelphia hospital about arranging a kidney transplant for her. But they still don't know if she will get it.


Earlier this month, Chrissy Rivera of Stratford, N.J., wrote an emotional blog post describing a meeting at Children's Hospital of Philadelphia in which she says a doctor and social worker declared Amelia ineligible for a transplant because she is "mentally retarded." The post inspired more than 37,000 people to sign an online petition demanding the hospital reconsider. Hundreds expressed outrage at the hospital's Facebook page and dozens wrote supportive blog posts.

On Monday, Rivera confirmed in an e-mail that she and her husband Joe have now had several additional phone conferences and meetings with hospital staffers, including one on Friday in which they were "given an hour-long presentation on what is involved in a kidney transplant."

She says: "At the end of this meeting, we were not told whether or not Amelia will be eligible, but we were given the required forms and steps we need to take to proceed with the transplant."

Hospital officials have not commented on any details, because of patient privacy rules. But the hospital has said that it does not deny transplants on the basis of mental disability and has performed them on children with all sorts of conditions.

Amelia has a genetic disorder called Wolf-Hirschhorn syndrome. It causes intellectual delays, seizures and other health problems -- and in her case has led to a kidney condition that could kill her in six months to a year, her parents say. They say they hope to find a family member or other living volunteer to donate the organ.

Transplant centers do routinely consider medical conditions and other factors that might make potential recipients poor candidates -- both because of the scarcity of donated organs and the often-difficult medical care needed after a transplant. The decisions are complex and must be made on a case-by-case basis, medical ethicists say. Denying a transplant on the basis of mental disability alone is illegal.

In an interview with the Philadelphia Inquirer, Chrissy Rivera said that "if there's a medical reason" that a transplant would be a bad idea, "of course we're not going to do it."

Meanwhile, the controversy has brought attention to a little-known disorder: The website where Rivera's story was posted has been viewed more than 387,000 times in less than three weeks, up from about 165 times a day, says the site's administrator, Kevin O'Brien of Elgin, Ill., father of another child with the syndrome. That should raise understanding of the disorder, he says, while also "focusing attention on the bigger issue of transplant rights for the disabled."

I hope and pray this little girl gets that special gift. A Kidney. She deserves to live a beautiful life as well as the rest of us.

God guide her and her family and do what is best! AMEN

The story behind Nick Cannon's "Mild" Kidney Failure

Dr. Manny Alvarez

In recent celebrity news, various media outlets are reporting that Nick Cannon, Mariah Carey’s husband and host of America’s Got Talent, has been hospitalized due to ‘mild kidney failure.’

First, I want to clear something up: There’s not such a thing as mild kidney failure. That’s like being a little bit pregnant.

Renal failure is either acute or chronic. Acute renal failure is the fast onset of failure of the kidney to remove waste from your body.

There are many factors that can contribute to kidney failure, ranging from severe dehydration, infection, side effects or toxicity from medications, severe bleeding and auto-immune diseases such as lupus.

Chronic kidney failure tends to develop over a period of years and is mostly due to chronic medical problems like diabetes or high blood pressure. There are some isolated genetic diseases that could also give you kidney disease or kidney failure over time.

However, the most likely explanation behind Nick Cannon’s hospitalization, based on some of the stories circulating, is that he is probably suffering acute renal failure.

Many of the symptoms of acute renal failure are not specific. They include decreased urine output, fatigue, abdominal pain, confusion, and body swelling.

However, if renal failure is not treated, the symptoms worsen. Ultimately, the patient develops seizures, then falls into a coma and could die. This is why I consider the kidney to be one of the most critical organs in the human body.

Now, treatment basically involves treating the underlying cause of renal failure. So, if failure is a result of infection, you would use antibiotics to treat the infection. If the cause is dehydration, you would hydrate the patient. For auto-immune diseases, you would likely use steroid therapy.

Sometimes, you can recover fully from acute renal failure, but in many cases, you can damage the kidney enough that it becomes a chronic disease.

Some of the ways doctors monitor patients for renal failure include blood tests looking for the presence of creatine, and ultrasounds or imaging of kidneys. In some cases, patients may need dialysis to filter out the excess waste that has built up in the body so the kidneys can take a little break.

No matter what, kidney failure is a serious problem, and the media should not trivialize a major health issue. It is important to realize how vital a healthy kidney is to our overall well-being.

Adult stem cells help kidney transplants

Adult stem-cell therapy may allow kidney transplant patients to dispense with anti-rejection drugs.

Adult stem-cell therapy using the kidney donor’s stem cells may help kidney transplant patients to get off of anti-rejection drugs. These immuno suppressive drugs make the patient more receptive to infections, making even the common cold potentially dangerous for them. They also may have other side effects of high blood pressure, diabetes, and cancer.

Dr. David Prentice of the Family Research Council tells OneNewsNow transplant physicians and researchers at Stanford University are injecting adult stem cells from the kidney donor into the recipient of the organ.

“Those adult stem cells get in there,” Prentice says. “They get into the bone marrow. They get into the immune system and they essentially form a system where that patient won't reject that kidney because it starts to look like some of their own tissue.”

Eight out of twelve transplant recipients were able to get completely off of anti-rejection medication after receiving the stem-cell therapy, although typically all transplant patients have to take the drugs or their bodies will reject the organ. Of these eight patients, seven have not used the drugs for over a year, and one of them has not used them for over three years. None of the patients suffered any adverse side effects from the treatment.

“Now keep in mind, usually they would have to take those drugs for the rest of their lives -- so this is a big step forward,” Prentice explains. “Again, using adult stem cells helps ease the transition.”

More than 70 uses of adult stem cells to treat diseases and medical conditions have been documented. In contrast, stem-cell research on human embryos, which involves killing a tiny human being, has produced no positive results.

Acute Renal Failure Update — Responses to Common Coding Issues

For The Record

A simple definition of acute renal failure is the sudden loss of kidney function resulting in partial or complete failure to filter waste products from the bloodstream with an accompanying accumulation of those waste products. The Acute Dialysis Quality Initiative proposed a classification scheme in 2004 called RIFLE: Risk, Injury, Failure, Loss, and End stage. Included in RIFLE was the definition of failure (any one of the following would indicate failure):

• a threefold increase in serum creatinine;

• a 75% decrease in glomerular filtration rate;

• 24-hour urine output of less than 0.3 mL/kg per hour; or

• anuria for 12 hours.

Acute renal failure is classified to ICD-9-CM category 584 with the specific code assignments as follows:

• 584.5, Acute kidney failure with lesion of tubular necrosis; Lower nephron nephrosis; Renal failure with (acute) tubular necrosis; Tubular necrosis, not otherwise specified; Acute tubular necrosis

• 584.6, Acute kidney failure with lesion of renal cortical necrosis

• 584.7, Acute kidney failure with lesion of renal medullary (papillary) necrosis; Necrotizing renal papillitis

• 584.8, Acute kidney failure with other specified pathological lesion in kidney

• 584.9, Acute kidney failure, unspecified; Acute kidney injury (nontraumatic)

Acute Kidney Injury

Physicians are now documenting the term acute kidney injury (AKI) to indicate damage to the kidney due to a rapid loss of renal function. Using the RIFLE criteria, AKI is defined as creatinine two times baseline or urine output of less than 0.5 mL/kg per hour for 12 hours. As of October 1, 2008, AKI (nontraumatic) is included in code 584.9.

Acute Renal Failure Secondary to Dye

Acute renal failure secondary to intravenous pyelogram dye is assigned to code 584.9 and code E947.8, Drugs/medicinal substances causing adverse effects in therapeutic use, as long as the test and dye were administered correctly. This is considered an adverse effect since the drug was given properly and the patient had a reaction to the substance that was administered correctly. For coding purposes, if the patient had an adverse reaction, the manifestation is sequenced as the principal diagnosis.

Acute Renal Failure in a Kidney Transplant Patient

If the patient is status post-kidney transplant and coming to the facility with acute renal failure, then sequence the complication of a transplanted kidney (996.81) as the principal diagnosis. “Either preexisting conditions or medical conditions that develop after the transplant are coded as complications of the transplanted organ only when they affect the function of that organ” (AHA Coding Clinic for ICD-9-CM, 1998, third quarter, pages 3-7).

Acute renal failure will affect the function of the transplanted kidney. Coding Clinic provides good examples of conditions that will affect transplanted organ function. Those conditions will affect the transplanted organ and therefore are coded as complications.

Acute Renal Insufficiency

Acute renal insufficiency (593.9), which refers to the early stages of renal impairment, is the sudden decrease of normal kidney function. Basically, it is abnormal lab results, including mildly abnormal elevated values of serum creatinine or blood urea nitrogen and diminished creatinine clearance. Treatment is directed toward treating the underlying cause without progressing to renal failure. Coders should not assign a code based on abnormal laboratory results alone; code assignment is based on physician documentation of a specific diagnosis.

Occasionally, physicians use the terms acute renal insufficiency and acute renal failure interchangeably. The physician should document the condition he or she believes is most appropriate based on the patient’s clinical picture. From a coding perspective, acute renal failure provides a more thorough description. The coder may need to ask the physician for clarification if the documentation is inconsistent or conflicting among the attending and consulting physicians.


If the physician documents azotemia, assign code 790.6, Abnormal blood chemistry. Prerenal azotemia is assigned to code 788.9, Other symptoms involving urinary system. However, it is appropriate to query the physician for clarification if acute renal failure is present.

Coding and sequencing for acute renal failure are dependent on the physician documentation in the medical record and application of the Official Coding Guidelines for inpatient care. Also, use specific AHA Coding Clinic for ICD-9-CM and American Medical Association CPT Assistant references to ensure complete and accurate coding.

An Apple a Day and Other White Foods for a Healthy Kidney Diet

We’ve all heard nutritionists promote health benefits of eating fruits and vegetables, often by comparing the benefits to produce colors. ‘Eat the rainbow’, ‘Taste a rainbow of fruits and vegetables’ are used to remind us about produce benefits. Even if you are on a kidney diet limiting your potassium, it’s still important to eat a variety and include allowed portions of lower potassium fruits and vegetables each day.

Beneficial phytochemicals such as carotenoids and flavonoids are present in colorful fruits and vegetables. These plantcompounds act as antioxidants, boost the immune system, fight inflammation and protect against cancer and cardiovascular disease.

But what about plain,white foods? A recent study in Stroke: Journal of the American Heart Association shows that plain white fruits and vegetables do provide health benefits. Dutch researchers studied consumption of different color fruits and vegetables over one year in over 20,000 people. Ten years later, follow-up study showed that those who ate more white-fleshed fruits and vegetables had a 52% lower risk of having a stroke compared to those who did not.

Linda M. Oude Griep, MSc, of Wageningen University in the Netherlands, says an apple a day “is an easy way to increase white fruits and vegetable intake,” but because other fruits and vegetable color groups also protect against chronic diseases, it’s important to eat a lot of different fruits and vegetables.

Foods in the white category include apples, bananas, cauliflower, chicory, and cucumbers. Garlic, ginger, jicama, mushrooms, onions, parsnips, pears, potatoes and turnips are also in the white-flesh produce group. Anthoxanthins are present in the white-colored pigments. Allicin, a compound that may help reduce blood pressure and cholesterol and lower the risk of cancer and heart disease are also present in the white-fleshed produce group.

For people following a low potassium kidney diet, be aware that bananas, parsnips and potatoes are high in potassium. Good news—the other white-fleshed fruits and vegetables are acceptable for a low potassium diet.

New Study Reconsiders Blood Pressure Targets for Kidney Disease Patients

Rates of Kidney Failure in Patients with Chronic Kidney Disease are Tied to Higher Blood Pressure Targets than Previously Advised

(NEW YORK, NY)—January 18, 2012 — High blood pressure has always been linked with chronic kidney disease (CKD), but doctors have debated for years what blood pressure targets would slow the disease’s progression toward kidney failure.

A new study, published in the January 9 issue of the Archives of Internal Medicine, indicates that blood pressure targets for those with kidney disease may have been more stringent than necessary. The findings could help doctors treat kidney disease patients who are also suffering from high blood pressure.

Using data from the National Kidney Foundation’s Kidney Early Evaluation Program (KEEP) database, doctors analyzed associations between blood pressure levels and End Stage Renal Disease (ESRD), or kidney failure, in patients suffering from Stage 3 and Stage 4 kidney disease. A higher risk for developing ESRD was observed among people with blood pressures of 140/90 or higher, but those who had blood pressure measurements of 150/90 and above were at highest risk. Currently, those with hypertension and CKD are advised to keep their blood pressures below 130/80.

Additionally, the study found that that more than 30% of people with CKD had blood pressures of >150/90, the highest risk group.

“Our study highlights the importance of blood pressure control in peoples with CKD, but it suggests that a target of 140/90 may suffice to delay progression to End Stage Renal Disease. Lower targets are extremely difficult to achieve in clinical practice where patients suffer from other conditions and take many medications. Our findings suggest to the clinician that efforts should concentrate on lowering the blood pressure of those extremely out of control, rather than fine-tuning the blood pressure of those already at 140/90,” said Dr. Carmen Peralta, the study’s lead author and member of the National Kidney Foundation’s KEEP steering committee.

Data for the study was gathered from more than 16,000 participants in the National Kidney Foundation’s Kidney Early Evaluation Program. The program offers free health screenings for individuals at increased risk of developing kidney disease. Since its inception, the program has screened more than 170,000 Americans.

The National Kidney Foundation is dedicated to preventing kidney and urinary tract diseases, improving the health and well-being of individuals and families affected by these diseases and increasing the availability of all organs for transplantation. For more information about risk factors and a schedule of KEEP screenings, visit

New Study Reconsiders Blood Pressure Targets for Kidney Disease Patients

Rates of Kidney Failure in Patients with Chronic Kidney Disease are Tied to Higher Blood Pressure Targets than Previously Advised

High blood pressure has always been linked with chronic kidney disease (CKD), but doctors have debated for years what blood pressure targets would slow the disease’s progression toward kidney failure.

A new study, published in the January 9 issue of the Archives of Internal Medicine, indicates that blood pressure targets for those with kidney disease may have been more stringent than necessary. The findings could help doctors treat kidney disease patients who are also suffering from high blood pressure.

Using data from the National Kidney Foundation’s Kidney Early Evaluation Program (KEEP) database, doctors analyzed associations between blood pressure levels and End Stage Renal Disease (ESRD), or kidney failure, in patients suffering from Stage 3 and Stage 4 kidney disease. A higher risk for developing ESRD was observed among people with blood pressures of 140/90 or higher, but those who had blood pressure measurements of 150/90 and above were at highest risk. Currently, those with hypertension and CKD are advised to keep their blood pressures below 130/80.

Additionally, the study found that that more than 30% of people with CKD had blood pressures of >150/90, the highest risk group.

“Our study highlights the importance of blood pressure control in peoples with CKD, but it suggests that a target of 140/90 may suffice to delay progression to End Stage Renal Disease. Lower targets are extremely difficult to achieve in clinical practice where patients suffer from other conditions and take many medications. Our findings suggest to the clinician that efforts should concentrate on lowering the blood pressure of those extremely out of control, rather than fine-tuning the blood pressure of those already at 140/90,” said Dr. Carmen Peralta, the study’s lead author and member of the National Kidney Foundation’s KEEP steering committee.

Data for the study was gathered from more than 16,000 participants in the National Kidney Foundation’s Kidney Early Evaluation Program. The program offers free health screenings for individuals at increased risk of developing kidney disease. Since its inception, the program has screened more than 170,000 Americans.

The National Kidney Foundation is dedicated to preventing kidney and urinary tract diseases, improving the health and well-being of individuals and families affected by these diseases and increasing the availability of all organs for transplantation. For more information about risk factors and a schedule of KEEP screenings, visit

Answering Your Questions About Living Donation

National Kidney Foundation

The following provides general information about living donation. For additional information about the evaluation process, the surgery, risks and making the decision, please visit, NKF’s Living Donors Web site. The Web site also includes ways to connect with other living donors and potential donors (through the Message Board, E-mail Discussion Group, and Pen Pals), stories about living donation, tributes to donors, and information about news and events

What is living donation?

Living donation takes place when a living person donates an organ (or part of an organ) for transplantation to another person. The living donor can be a family member, such as a parent, child, brother or sister (living related donation).

Living donation can also come from someone who is emotionally related to the recipient, such as a good friend, spouse or an in-law (living unrelated donation).

In some cases, living donation may even be from a stranger, which is called nondirected donation.

What organs can come from living donors?

The organ most commonly given by a living donor is the kidney. People usually have two kidneys, and one is all that is needed to live a normal life. Parts of other organs including the lung, liver and pancreas are now being transplanted from living donors.

What are the advantages of living donation over nonliving donation?

Transplants performed from living donors have several advantages compared to transplants performed from nonliving donors (individuals who have been declared brain dead and their families have made the decision to donate their organs):

Some living donor transplants are done between family members who are genetically similar. A better genetic match lessens the risk of rejection.

A kidney from a living donor usually functions immediately, making it easier to monitor. Some nonliving donor kidneys do not function immediately and as a result, the patient may require dialysis until the kidney starts to function.

Potential donors can be tested ahead of time to find the donor who is most compatible with the recipient. The transplant can take place at a time convenient for both donor and recipient.

Are transplants from living donors always successful?

Although transplantation is highly successful, and success rates continue to improve, problems may occur. Sometimes, the kidney is lost to rejection, surgical complications or the original disease that caused the recipient’s kidneys to fail. Talk to the transplant center staff about their success rates and the national success rates.

Where can I find statistics related to living donation?

You can find some statistics on the United Network for Organ Sharing (UNOS) Web site. UNOS compiles statistics on every transplant center in the U.S. Go to to view all UNOS data. You can find statistics on the number of nonliving and living donor transplants performed at that particular center as well as the graft survival rates for the transplant recipient, the center and additional information about donation and transplantation.

The best source of information on expected donor outcomes is from your transplant team. See the list of “Elements of Disclosure” at (page 3) for a list of issues to discuss with our transplant team. You can also check for additional information about donation and transplantation.

Please visit NKF’s website on living donation at for detailed information.

If you would like to become a volunteer and find out more about what's happening where you live, contact your local NKF Affiliate.

If you would like more information, please contact us.

©2012 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. No one associated with the National Kidney Foundation will answer medical questions via e-mail. Please consult a physician for specific treatment recommendations.

Kidney Health - The Key To Longevity

Modern science has confirmed that kidney health is indeed critical for the overall health of the body. Kidneys failure is often linked to problems occurring in other organs and systems that lead to diseases and common ailments.

High blood pressure, fatigue, impotence, joint and back pain, even ringing in the ears can all be symptomatic of unhealthy kidneys.

Many regard kidney health as the key to longevity. And Marvlix, Elixir Industry's proprietary production of Cordyceps sinensis, is the key to kidney health.

While we don't have a complete understanding of the reasons that Cordyceps has such a remarkable effect on kidney health, scientists have made great progress in this regard over the last 10 years. In 1998, Dr. Zhou and his team discovered that the renal health-enhancing potential of Cordyceps may come from its ability to increase 17-hydroxy-corticosteroid and 17-ketosteriod levels.

Chronic renal failure is a life-threatening condition that often affects the elderly. In a 1992 study of 51 patients with chronic renal failure, Dr. Guan and his colleagues found that the group of patients receiving 3-5 grams of Cordyceps sinensis per day showed significantly improved kidney function and overall immune function, as compared to the placebo group.

Patients with kidney problems often suffer from hypertension, proteinuria and anemia. In a study involving such patients, a 15% decrease in blood pressure was observed after one month on Cordyceps. Urinary protein was also significantly reduced. In addition, an increase in superoxide dismutase was observed and documented. The study further suggested an increase in the free radical-scavenging capability of oxygen in the bloodstream, which would result in reduced oxidative cellular damage.

In another clinical study, 57 patients with gentamicin-induced kidney damage were treated with 4.5 grams of Cordyceps per day or by other, more conventional methods. After six days, the Cordyceps group had recovered 89% of normal kidney function, while the control group had recovered an average of only 45% of normal kidney function. The time-to-recovery was also significantly shorter in the Cordyceps group as compared to the control group.

YouTube - Fistula

When I do my dialysis I have what is called a Fistula that is placed in my arm. Watch this informative video.

Fistula in the lower part of the Arm

This is what most Fistulas look like today compared to the old days. They are so much Nicer and easier to maintain. The new technique for these Fistulas are called buttonholes. Will explain the next time.

Buttonhole Technique

What is the track?

The track is a tunnel that is created

by the formation of scar tissue –

exactly like the hole created in an

earlobe for a pierced earring. This

track goes from the surface of

your skin to the outside wall of

your fistula (blood vessel wall).

Once the track is well healed, there

are no nerves or tissue in the path

of the needle to cause you pain.

Why would I want the

buttonhole technique used

on my fistula?

Research has shown that there are:

9 Fewer infiltrations (swelling

from the needle going

through the fistula wall).

9 Fewer missed attempts to

place needles.

9 Less pain when inserting


There are dialysis patients who

have been using this technique for

over 20 years with the same AV


What is the buttonhole


Buttonhole technique is another

way of cannulating (putting

needles in) your fistula. It requires

putting the needles in the exact

same spot at the same angle and

depth every time your needles are


But, my doctor told me not

to let the staff put the

needle in the same place

because that could cause an


Can I use the buttonhole

technique on my access?

This technique is only for use

with AV fistulas, not AV grafts.

Check with your nephrologist or

dialysis nurse to see if this

technique would work for your


In the picture, the needle is

placed in the same small area

over and over (“one-site-itis”).

This causes the wall of your fistula

Is the buttonhole technique

a new procedure?

No - the buttonhole technique has

been used on AV fistulas in

Europe for more than 25 years. It

was first used on a patient who

had very limited surface area for

cannulation. It was so successful

that other patients wanted to have

their fistulas cannulated using the

buttonhole technique. Because

there is little to no pain associated

with buttonhole cannulation,

patients are more willing to learn

to cannulate their own access

using this technique.

Buttonhole technique is becoming

very popular in the United States.

Up until a few years ago, the blunt

needles, preferred for this technique, were not available in

the United States.

What do you mean by the

term “blunt” needles?

Blunt needles are rounded on the

top and do not have a sharp,

cutting edge like traditional dialysis

needles do.

Since your access is entered

through a specially formed track,

there is no need for sharp needles.

Blunt needles help to prevent

problems like cutting or scraping

the newly formed track that can

cause oozing around your needles

during dialysis.

One big advantage of the blunt

needles is that they prevent you

from accidentally sticking yourself.

to weaken and balloon out,

forming an aneurysm. In the

bottom picture, the needle goes in

the exact same hole every time –

this does not cause an aneurysm.

Part 2 Buttonhole technique

Is the buttonhole technique

a new procedure?

No - the buttonhole technique has

been used on AV fistulas in

Europe for more than 25 years. It

was first used on a patient who

had very limited surface area for

cannulation. It was so successful

that other patients wanted to have

their fistulas cannulated using the

buttonhole technique. Because

there is little to no pain associated

with buttonhole cannulation,

patients are more willing to learn

to cannulate their own access

using this technique

Buttonhole technique is becoming

very popular in the United States.

Up until a few years ago, the blunt

needles, preferred for this

technique, were not available in

the United States.

What do you mean by the

term “blunt” needles?

Blunt needles are rounded on the

top and do not have a sharp,

cutting edge like traditional dialysis

needles do.

Since your access is entered

through a specially formed track,

there is no need for sharp needles.

Blunt needles help to prevent

problems like cutting or scraping

the newly formed track that can

cause oozing around your needles

during dialysis.

One big advantage of the blunt

needles is that they prevent you

from accidentally sticking yourself.


Prepare for Atlantic Hurricane Season - Season

Dialysis Provider Offers Resources for Possible Weather-Related Emergencies

Duel Debate Module

Would you donate your organs to someone who needed them more?

Guestbook Comments

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    • Lorrie45 profile imageAUTHOR


      7 years ago

      Also, If you learned something, read or would like to share,Please don't hesitate to share that info here. Every little knowledge helps.

    • Lorrie45 profile imageAUTHOR


      7 years ago

      Anytime my friend. I hope I am helping. I was at a lost when I started out and wanted to share what I know, researched and learned with others.

    • Countryluthier profile image

      E L Seaton 

      7 years ago from Virginia

      Very informative lens. From the outside, we are oblivious to all the life changes it causes. THanks for sharing.


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