Kidney dialysis technology and patient outcomes

Kidney Failure

Elke

KIDNEY FAILURE: PREVENTION WHEN THERE IS NO CURE

Kidney Failure: Prevention When There Is No Cure

Kidney Failure: Prevention When There Is No Cure

As of 2007, an estimated 11% of Americans over the age of 20 have kidney disease (National Kidney and Urologic Diseases Information Clearinghouse, 2011). Kidney disease can lead to kidney failure if left untreated. Kidney failure occurs when the kidneys can no longer perform the blood-filtering role that they are intended for; therefore the toxins that would normally be removed from the blood accumulate in the body, causing downstream problems including further organ failure (Jacobs, 2009). Dialysis is a common treatment for people with kidney failure, yet of patients receiving dialysis, the morality rate is still approximately 50% (Kalra, 2002).

My sister, Stacey, has undergone dialysis for kidney failure for the past 10 years. In November of the year 2000 Stacy fell down some stairs at work and ended up going to the hospital to be checked out. At this time, she was first told that she was showing signs of kidney failure. At first her mother, daughter and sisters among other family members were worried and upset. However, Stacy was, and still is determined to not let her illness take over and claim her life. She went on dialysis and began the process of becoming a candidate for kidney transplantation. Stacy had her first dialysis treatment in March 2001. Since then, she has had a stroke, her shunt unclogged twice, and one failed transplant. Stacy lost her transplanted kidney after only three years and is now back on dialysis in the process of becoming once again a candidate for kidney transplantation.

The following paper discusses the technology of kidney (renal) dialysis. Dialysis is a life-saving therapeutic treatment for kidney disease. First a historical perspective is given through discussion on the topic. Then a personal historical perspective is given; this section relates to the personal relevance of the issue to my own background and family history of dialysis. A conclusion highlights the salient points of the paper for topic synthesis.

Part I: Historical Context of Dialysis

Kidney Disease -- Conceptual Overview

Most people are born with two functional kidneys; the job of the kidneys is to filter the blood of toxins and waste materials. Kidney disease can be caused by diabetes, high blood pressure, toxic accumulation of drugs such as antibiotics or chemotherapeutics, and other conditions (Goldsmith, Jayawardene, & Ackland, 2007). Kidney disease both acute and chronic, relates to the decreasing function of the kidneys to perform this essential role. Wastes accumulate in the blood, leading to illness. Secondary complications and effects of kidney disease include high blood pressure, anemia, decreased nutritional status, weakened bones, and nerve damage; additionally, the person with this condition also is at an increased risk of stroke and heart attack (National Kidney Foundation, 2011). Early diagnosis of the condition enables an early treatment protocol, allowing for a mitigation of the progression of the disease. Many people can live for years on dialysis (Goldsmith, Jayawardene, & Ackland, 2007).

Impact on Professional Development

In 1943 a Dutch physician, Willem Kolff, invented the first dialyzer, a machine used in dialysis (Nissenson & Fine, 2005). The use of the dialyzer has given people a new lease on life, whom otherwise would have died of kidney failure. Peitzman (2001) notes the alacrity with which the invention of renal dialysis was greeted. The invention of the dialyzer allowed the specialty of nephrology to evolve. In the instance of chronic kidney failure, the invention of the shunt by Quinton and Scribner further supported patients through maintenance treatment. Other notable inventions for use in patients with kidney failure include the chronic dialysis unit the rise of the national dialysis chain. A federal entitlement program supported the widespread use of maintenance dialysis, in addition to disposable supplies. With the emergence of the specialty of nephrology, many new doctors were trained in the field for clinical practice (Peitzman, 2001).

Kidney disease and its symptoms were once known as Bright's Disease, named after the English physician Richard Bright, who formally described the condition in 1827 (Goldsmith, Jayawardene, & Ackland, 2007). As the field of nephrology advanced, the specific names for kidney disease became named for their known causes; for example, the factors of genetics, drugs, illness, or other conditions may lead to kidney disease (National Kidney Foundation, 2011). The advance of the dialyzer and the rise of nephrology completely changed the face of medicine for this condition both in terms of professional development of healthcare practitioners as well as for the prognosis of the patient.

Impact on Individual Behavior

While every year 100,000 people in the United States are diagnosed with kidney disease, the use of dialysis for treatment allows these patients to live with their condition (National Kidney and Urologic Diseases Information Clearinghouse, 2011). In a social context, the existence of kidney disease is no longer an issue confined to medicine; the medical model of disease may have allowed for the characterization of the condition and the invention of treatments, yet now a more person-centered approach exists in patient care (Ginieri-Coccossis, Theofilou, Synodinou, Tomaras, & Soldatos, 2008).

This person/patient-centered perspective means that people have choices in managing their condition; the diagnosis of kidney disease is not a death sentence; rather, it is a diagnosis in which options exist that allow the person to continue to live their life, such as working, parenting, and being active members of society (Goldsmith, Jayawardene, & Ackland, 2007).

Part II: Personal Historical Perspective

Impact on My Family

The appreciation for dialysis technology was not of much concern to my family until my sister was diagnosed with failing kidneys in November of 2000. My sister had her first dialysis treatment in March of 2001. I have witnessed my sister experiencing the ups, downs, twists and turns of coping with kidney failure.

My sister was on dialysis for five years before being fortunate enough to receive a kidney transplant. It is true that receiving dialysis treatments requires a major life change, even if the patient does rather well with it. With the supervision of their kidney doctor, if the dialysis patient follows dietary and lifestyle recommendations to benefit themselves, they can increase their life expectancy and quality of life (Anees, Hameed, Mumtaz, Ibrahim, & MN., 2011).

Impact on My Community

Unfortunately I have an increased risk of developing chronic kidney disease. The conditions that make me more likely to develop kidney disease are diabetes which is a leading cause of kidney failure, high blood pressure which is the second leading cause and a family history of kidney failure (Townsend & Cohen, 2009). It is also important to mention that Hispanic-Americans have nearly twice the risk of non-Hispanic whites in developing chronic kidney disease (Lora, et al., 2009).

Impact on My Education

When it comes to your health, ignorance is not bliss. Indeed, while it can be frightening to learn of one's propensity for an illness or of an actual illness, it changes one's perspective. I am not different in this regard; witnessing my sister having gone through the psychological and physiological factors associated with her dialysis treatment, and knowing my own risk, has been illuminating and has given me the impetus to learn about how to deal with the condition.

For me, early detection will be key. Patients who have early detection of kidney disease have a better overall prognosis through getting earlier treatment (Black, et al., 2010). Furthermore, knowing what exacerbates the condition in different presentations of kidney disease will modify my life selections; for example, I must be particularly aware of the effects of antibiotics on my kidneys and work with my doctors to select medicines with low impact on the kidneys given my family history for the condition (Loh & Cohen, 2009).

Yet given my family history to development of the condition, I am reassured to some extent that the existence of the technology of dialysis can afford me a way to continue to live. There are many organ failures that without a transplant end in certain death, such as heart failure, lung failure, and liver failure. There is no relative treatment for those organ failure conditions such as there is for kidney disease.

Conclusion

Kidney disease is a failure of the kidneys to effectively filter wastes and toxins out of the blood; left untreated, the condition can lead to secondary conditions as well as total kidney failure. The medical technology of dialysis allows the patient with kidney disease to continue to live with their condition in a manner that while incorporating the treatment, still offers some quality of life in terms of being active in their environment to a significant degree. My own family history predisposes me to the condition, which through awareness and education I can learn how to mitigate the onset of the disease, and if it does manifest, be aware of the treatment choices and impacts of those that currently exist.