Diet & Exercise for CKD

End Stage Kidney Disease (ESKD)...

The Show Is Over

In the early stages of CKD, renal replacement therapy is not needed. While not fully functional, the beans can still 'hum' along.
Once at Stage 5, End Stage Kidney Disease or ESKD, the kidneys have actually failed to the point of needing the 'back-up singers' to take over.
There are basically three options (modalities) in place that are used as renal replacement therapies. Of course nothing is available that can perfectly replace the original 'instrument'!
The guideline for starting a replacement 'mode' is based on remaining function at or below 15%, coupled with symptoms of ESKD.

Pump Up the Volume

Kidney failure can be supported by giving treatments called dialysis, which comes in two 'versions'.
The more 'popular' type is hemo (or blood) dialysis.
Most often done in an out-patient center, hemodialysis requires a way to access the blood stream.
Surgery to create grafts or fistulas (typical types of access) are usually placed in the arm.
A 'sharp' needle is used to get the blood.
Sometimes a catheter in a blood vessel is needed when the arm access is not mature ('flat').
Treatments are 'set' for 2-3 times a week and frequently last for 4 hours.
Dirty blood is 'pumped' out of the body, cleaned and returned using special equipment and a complex treatment prescription provided by the doctor.
'Measured' excess fluid, along with waste material, are removed from the body.
Patients may choose to do this dialysis treatment at home, but it requires a 'duet' (two people) to learn how to administer the equipment.

The Beat of a Different Drum

The second type of dialysis therapy is called peritoneal (or belly) dialysis.
This is a treatment that is 'performed' by the patient at home.
Even thought it is a 'solo' gig, it is most desireable to have a family member or friend learn the procedure as well.
The filter in peritoneal dialysis is the lining of the abdominal cavity (called the peritoneum).
Special fluid is placed in the peritoneum through a catheter (tube) that has been surgically placed.
The fluid dwells for several hours and the filtration allows waste and excess fluid to be pulled into the space.
The cavity is then drained to remove the dirty fluid - and clean fluid is again put inside.
These exchanges can happen periodically throughout the day, or, by using a machine at night, while at 'rest'.

I've Got A New Song to Sing

The final modality to review is transplantation.
This ranks on the top of the 'charts' for best treatment type.
Most kidney donations come from accident victims, however, sometimes people will give a live donation to a friend or relative in need.
The most important step to determine if the kidney will work is the tissure typing.
Our bodies natural defense mechanism is to fight off foreign bodies, so a foreign kidney, even if a match, will create the body to go into rejection mode