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Kidney Disease: The Silent Striker 
 
Bob Schmitz may be closing in on 90 years old, but he’s still punching the clock at his part-time job.

“I come here a few times a week and each session is three and a half hours,” says Schmitz.  “I tell everyone I go to work.  It’s really not that bad.”

Schmitz’s “job” isn’t really one at all, but rather an appointment at the St. Mary’s Renal Center for dialysis. 

“It all started a couple of years ago.  First, I noticed I was feeling poorly and things became tough,” he says, “Then I visited my doctor and he sent me over here to the dialysis center to be checked out.”

Tests showed Schmitz had kidney cancer.  So last May he had surgery to remove the tumor and the kidney it was attached to, leaving just one functioning kidney.  Unfortunately, that remaining kidney wasn’t able to fully filter his blood and Schmitz was told to prepare for dialysis.

“I had an issue initially with dialysis.  I didn’t want to feel tethered to this machine,” he says, “But in talking to different people the one thing that occurred to me was I should treat it like I was going to work and that rang a bell.  You can’t really complain about three and a half hour sessions three days a week.”

Dialysis is something millions of Americans like Schmitz may have to get used to.  Chronic kidney disease is estimated to affect more than 26 million nationwide. And African Americans are four times more likely than their Caucasian counterparts to develop it.  Kidney disease means the organ’s ability to filter blood has been greatly reduced. 

There are a number of causes of kidney disease.  However, in many cases, the culprits are high blood pressure and/or uncontrolled diabetes.

“High blood pressure can destroy the filters in the kidneys,” says Swaim. “And with diabetics, the high levels of glucose in their blood has the same effect.

Kidney disease isn’t something that will all of a sudden hit you.  Instead, it tends to come on slowly.  Most people with early stage kidney disease don’t even know they have it.  Yet a simple test at your doctor’s office can help determine if you have a problem.

But, those with advanced stages do have symptoms.  These include swollen ankles, difficulty concentrating, fatigue, decreased appetite and blood in the urine.  If you are diagnosed, chances are dialysis could lead to a better quality of life. 

“Dialysis has two functions,” says Swaim. “First, to remove extra fluid built up in the bloodstream.  And second, to filter out the waste product that the kidneys aren’t able to filter.”

Without this filtering, you can feel rundown all the time like you have the flu.  And in the end, the buildup of waste produce can even be fatal.    

“Patients won’t immediately feel a difference the first time they have dialysis.  But after three to four weeks they start to really feel better,” says Swaim.  “Often they say, ‘wow, I didn’t realize how sick I was. I feel so much better now.’”

That’s exactly what happened to Schmitz.

“I feel better when I leave here each time,” he says.

But getting patients to this point is one of the hardest parts of Swaim’s job.

“For some people – and understandably so – they don’t want to come.  It is a huge adjustment to realize this is what you’ll need to do to continue feeling good,” she says.

But that’s why patients meet with a care team first to learn all about the process.

“We have a team of people who work with patients for both emotional support and also to let them know what resources are available.  We show them websites they can visit to learn more about their disease and have them meet with dietitians who can offer tips to control their thirst or reduce their potassium,” she adds.

Recently, within the past few years, a new treatment option has been added for patients – homecare.  Typically, dialysis means you’re driving to a dialysis center to spend three hours a day, three days a week there.  But now, equipment that can be used at home gives people more flexibility.

“In order for patients to train for hemodialysis, the type of dialysis done with a needle, they need a dedicated partner who’s with them for every treatment if they’re going to do it at home.  It’s something that can’t be done alone,” she says.

If a patient wants to consider this option, doctors first meet with them to make sure they’re a good candidate.  Then the patient and their partner are trained.  The whole process takes about two to three weeks.  Once trained, a dialysis nurse will stop by the patient’s home to make sure everything is being done properly.  If there are any questions, an on-call nurse also is available 24 hours a day.

“Patients do visit our renal center even when on home dialysis,” says Swaim.  “But it’s only once a month and that’s just to run lab work and check on the patient to make sure they’re doing well and are taking their medications on a regular basis.” Home dialysis patients also can temporarily go back to in-center dialysis. This option is very helpful if, for example, their partner will be out of town and not available to help. 

For Schmitz, coming to the St. Mary’s Renal Center for treatment is just fine.  It gives him time to chat, catch up on reading, even relax and watch TV. 

And most importantly it gives him time to focus on his goal, “to play golf with my five grandsons next year when I’m 90!”

 

BREAKOUT: What is Kidney Disease?

Chronic kidney disease affects more than 26 million people in the United States or roughly one in eight people.  It’s most commonly caused by high blood or diabetes that are not controlled.  Both cause the kidney’s filtering system to become damaged.  Kidney disease it the term used when that damage is severe and the filtering has been greatly reduced.

BREAKOUT:  Who’s at Greatest Risk for Kidney Disease?

  • It affects 1 in 8 Americans
  • African Americans are at a four times higher risk
  • Those with high blood pressure
  • Those with uncontrolled diabetes
  • Those with a family history of kidney disease
  • Anyone over age 60

BREAKOUT: When Should I Get Tested?

Talk to your doctor if you have a family history of kidney disease.  A simple test can tell you if you have signs of kidney disease, too.  If you have high blood pressure or diabetes, do what you can to keep this in check as they’re the cause of 70 percent of all kidney disease.

BREAKOUT: Is it Treatable?

Kidney disease is not curable, but when caught early, medication can help.  If discovered in the later stages, your doctor will know if dialysis is the way to go.  Not only can it make you feel better, it can also help your kidneys work without being overloaded and therefore prolong your life.

 

   
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