Kidney (Renal) Dialysis and Transplant |
| Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer |
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Overview |
| There are two primary treatment options for end stage renal disease, dialysis and transplant. Dialysis is an artificial system for cleansing the blood. Kidney transplantation is a surgical procedure that places a healthy, donated kidney into the patient with kidney failure. |
| The question of the best method of treatment is a difficult one to answer. There are several issues that need to be addressed. The advantages and disadvantages of each kind of treatment affect each person differently. Renal patients should learn all they can about each method of treatment. Treatment should be tailored to meet the individual's need so that she/he can remain as self-sufficient as possible and continue to be a productive member of society. Emory Transplant Center |
Renal Dialysis |
| When the kidneys fail, dialysis of some form must be instituted to take over the work of the failed kidneys. There are two types of kidney dialysis: hemodialysis and peritoneal. |
| FAQ about Dialysis Dialysis is a treatment that does some of the things done by healthy kidneys. It is needed when your own kidneys can no longer take care of your body's needs. You need dialysis when you develop end stage kidney failure --usually by the time you lose about 85 to 90 percent of your kidney function. NKFI. |
| Scleroderma Renal Crisis (SRC). This study shows that dialysis is frequently indicated but can be stopped in about half of patients, mainly those with good blood pressure control. PubMed, J Rheumatol, 2014 Jun;41(6):1040-1048. (Also see: What is Scleroderma?) |
| Renal manifestations of systemic autoimmune disease: diagnosis and therapy. Renal involvement is relatively common in certain systemic autoimmune diseases, but can be clinically silent. Scleroderma renal crises are managed by blood pressure control using angiotensin-converting enzyme inhibitors and other agents as required. Dialysis and transplantation can be successful in these conditions. PubMed, Best Pract Res Clin Rheumatol. 2004 Jun;18(3):411-27. (Also see: Renal Involvement) |
Hemodialysis |
| Home Hemodialysis. In 1960, Dr. Belding Scribner and his colleagues in Seattle demonstrated for the first time that patients with chronic kidney failure could be kept alive for long periods with the use of an artificial kidney. Within a few years, the idea was developed to treat patients with the artificial kidney in their homes. Home hemodialysis is now accepted as an excellent method of caring for patients with kidney failure. NKFI. |
| Improving Quality Of Life For Dialysis Patients. The mission of the Cincinnati Dialysis Access Research Program (CAP) is to improve the quality of life for dialysis patients by reducing the problems associated with dialysis vascular access. Medical News Today. 09/15/07. |
| Association between calciphylaxis and inflammation in two patients on chronic dialysis. The interactions between inflammation-mediated changes in the levels of endogenous inhibitors of calcification and abnormalities in calcium-phosphorus metabolism merit intensive study in the future as potential mechanisms of calciphylaxis. PubMed, Adv Perit Dial. 2006;22:171-4. (Also see:Calcinosis) |
Peritoneal Dialysis |
| Peritoneal Dialysis. With peritoneal dialysis (PD), you have some choices in treating advanced and permanent kidney failure. Since you don't have to schedule dialysis sessions at a center, PD gives you more control. You can give yourself treatments at home, at work, or on trips. NIH. |
| Management of Scleroderma-related End-stage Renal Disease With Automated Peritoneal Dialysis. We report a patient with scleroderma-related end-stage renal disease treated with automated peritoneal dialysis with steady state control of uremia and hypertension at 18 months of follow-up. Pavan M. (PubMed) Iran J Kidney Dis, 2010 Apr;4(2):162-3. |
Treatment Methods for Kidney Failure: Peritoneal Dialysis The most common form of PD, continuous ambulatory peritoneal dialysis (CAPD), does not require a machine. As the word ambulatory suggests, you can walk around with the dialysis solution in your abdomen. Other forms of PD require a machine called a cycler to fill and drain your abdomen, usually while you sleep. The different types of cycler-assisted PD are sometimes called automated peritoneal dialysis, or APD. NIDDK.
The cycler — which automatically fills and drains your abdomen, usually at night while you sleep — can be programmed to deliver specified volumes of dialysis solution on a specified schedule. NIDDK. |
| Kidney Options. See: Continuous Cycling Peritoneal Dialysis. Kidney Options. |
Anemia and Erythropoietin |
| Anemia in Kidney Disease and Dialysis Anemia is common in people with kidney disease. Healthy kidneys produce a hormone called erythropoietin, or EPO, which stimulates the bone marrow to produce the proper number of red blood cells needed to carry oxygen to vital organs. Diseased kidneys, however, often do not make enough EPO. As a result, the bone marrow makes fewer red blood cells. If no other cause for EPO deficiency is found, it can be treated with a genetically engineered form of the hormone, which is usually injected under the skin two or three times a week. NIDDK. (Also see: Anemia) |
Diet and Dialysis |
| Well Nourished Patient Once a patient begins dialysis treatments, there are four main restrictions to their "renal diet": Fluids, Sodium (Na), Potassium (K), and Phosphorus (P). RenalWEB. |
Kidney Transplant |
| Kidney Transplant. End-stage renal disease is the name for kidney failure so advanced that it cannot be reversed. End-stage renal disease cannot be treated with conventional medical treatments such as drugs. Only 2 treatments allow you to continue living when your kidneys stop functioning: dialysis and kidney transplantation. Medscape. |
| Fatigue effects in daily life activities of kidney transplant recipients. Fatigue is directly related to the level of activities of daily living, causing less ability to perform activities in the higher level of fatigue, which is in the immediate postoperative period and only settling fully on the 9th postoperative day. PubMed, Transplant Proc, 2014 Jul-Aug;46(6):1745-9. (Also see: Fatigue) |
Research |
| Impact of iron treatment on immune effector function and cellular iron status of circulating monocytes in dialysis patients. Iron is used as an adjunct therapy to treat anaemia in dialysis patients. However, iron may harbour detrimental effects in being a nutrient for invading pathogens or by modulating immune pathways. Thus, we prospectively studied the effects of iron treatment towards monocyte immune function. Sonnweber T. (PubMed) Nephrol Dial Transplant, 2010 Sep 8. |
| When pure is not so pure: chloramine-related hemolytic anemia in home hemodialysis patients. Worldwide, chloramines are used as the preferred disinfectant for city water supplies. Although they have distinct advantages compared with chlorine and are deemed harmless to the general population, hemodialysis (HD) patients are at risk from chloramine-induced hemolytic anemia. Junglee NA. (PubMed) Hemodial Int, 2010 Jul;14(3):327-32. |
| Far-infrared (FIR) therapy: a novel treatment to improve access blood flow and unassisted patency of arteriovenous fistula in hemodialysis (HD) patients. FIR therapy, a noninvasive and convenient therapeutic modality, can improve access flow (Qa) and survival of the arteriovenous fistula (AVF) in HD patients through both its thermal and its nonthermal effects. J Am Soc Nephrol. 2007 Mar;18(3):985-92. |
Patient Support |
| National Kidney Foundation Inc. The National Kidney Foundation, Inc., a major voluntary health organization, seeks to prevent kidney and urinary tract diseases, improve the health and well-being of individuals and families affected by these diseases, and increase the availability of all organs for transplantation. NKFI. |
Personal Stories |
| Anita A: Sister of Systemic Scleroderma Patient She has had a heart transplant and a kidney transplant. It has been amazing to our family the courage and stamina that she has through all that she has endured... |
| Archie Bailey: Scleroderma: Sue's Story Time has passed since Sue's death. Only those who have experienced the grieving process can understand... |
| Corey C: Surviving Daughter of Scleroderma Patient It was a very long process and scary because she really did not know what to expect next... |
| Judy Dee: Diffuse Scleroderma My skin began to harden and turn a shade of brown... |
| Robin H: End-Stage Renal Disease (ESRD)/Transplant Recipient It has been almost two years now since my kidney transplant. I am doing better than ever... |
| (Turkish) Ruko: Sistemik Skleroz Mart itibari ile sistemik skeleroz tanisi ile Cerrahpasa Tip Fakultesi Romotoloji servisinden taburcu oldum... |
| Sandy: Diffuse Scleroderma After years of complaining about various symptoms to doctors, I was diagnosed with Diffuse Scleroderma in 1993... |
| Sherrill: Diffuse Systemic Scleroderma (New Zealand) I could no longer walk, due to knee contractures. My hands resembled claws. I had elbow contractures and neck contractures, and could not straighten my arms... |
| Sherrill: My Experience with Anemia Since I became ill with diffuse scleroderma just over eight years ago, I have found that anemia is a quite complex subject... |
| Susan H: Eosinophilic Fasciitis While I was in the hospital and starting dialysis, my right arm became hard as a rock and swollen... |
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| Scleroderma Kidney Involvement ISN. |
| What is Scleroderma? ISN. |