HDC Fluid Restriction Calculator

Home Dialysis Central has published a Dialysis Fluid Restriction Calculator to answer the question, “How much can I drink between dialysis sessions?” individualized for each patient.  For the Calculator and discussion, see https://homedialysis.org/news-and-research/blog/265-a-new-dialysis-fluid-restriction-calculator.

Preventing Organ Stunning

Home Dialysis Central has published a summary of “organ stunning,” where dialysis removes too much water, or removes it too quickly, and your internal organs are shocked.  This can damage your organs, and the damage may be cumulative.  The HDC article covers the causes and processes of organ stunning, and most important, describes how you can avoid it.  Find the article at https://homedialysis.org/life-at-home/articles/organ-stunning-on-hemodialysis-what-is-it-and-what-can-you-do.

DFC January Update

CMS has announced that new data on the care quality of dialysis facilities is now available on Dialysis Facility Compare (DFC), the website that allows patients and health centers to view and compare quality data about dialysis facilities.  CMS uses this data, organized into a series of measures, to create a 5-Star Rating system that can help patients make educated decisions about where to get their dialysis treatments, as well as to assist them in speaking with their healthcare team regarding their care.

The January revision has updated information for Standardized Transfusion Ratios, Standardized Mortality Ratios, Standardized Hospitalization Ratios, Standardized Readmission Ratios, vascular access types (fistula and catheter), bloodstream infections, hemoglobin management, and the CAHPS survey on in-center hemodialysis patient experience.  The July 2017 DFC data for dialysis adequacy, hypercalcemia, serum phosphorus, and the facility Star Ratings will remain until the next update.

Find DFC at https://www.medicare.gov/dialysisfacilitycompare/#.

If you’re computer-savvy, you can download supplementary DFC data from https://data.medicare.gov/data/dialysis-facility-compare.

Mentoring and Missed Treatments

The Mid-Atlantic Renal Coalition, ESRD Network 5, has developed a program for training dialysis patients to be mentors and mentees, and a test of the program has successfully reduced the number of missed dialysis treatments.  Missed and shortened treatments can result in fluid management problems, unhappy patients, and unnecessary hospitalizations.  The program is briefly described in Nephrology News & Issues, at http://www.nephrologynews.com/peer-mentoring-reduces-missed-dialysis-treatments/ .  Network 5 has made all of the materials for the program, which they call Peer Up!, available for free download, at http://esrdnet5.org/Peer-Up!-Program-Toolkit.aspx .  The Peer Up! Toolkit includes six sections: Background and Overview, Program Management, Recruitment and Retention, Mentor Training, Patient Support Resources, and Assessment and Evaluation.  Both mentees and mentors reported improvements in psychosocial and physiological factors.

What to Do While You’re on Dialysis?

We’ve put our latest patient flyer/poster onto the Network website, at https://www.nwrn.org/patients-a-family/ptedres/mon.html .  The June poster is on “Passing the Time While on Dialysis,” and tallies recommendations from patients who are on the Network’s Learning and Action Network.  Making the effort to keep yourself entertained or otherwise engaged – or to catch up on your sleep or meditation – while you’re on dialysis will help you enjoy staying “just a little bit longer.”  When you stay for your full sessions, you’ll feel better for the rest of the week, and have fewer health emergencies.  To find out more about the Network Learning and Action Networks, see https://www.nwrn.org/providers-and-professional-staff/ptcenter/lanstaff.html .

New Patient Newsletter and Poster

We’ve put the latest issue of Network Consumer News on the Network website at https://www.nwrn.org/patients-a-family/ptedres/ncn.html .  This issue is on “Plan of Care Meetings: Just as Important as Treatments!” and as usual includes editions in large print and in Spanish.  The issue also includes notes on “What should I do if the dialysis center is closed for an emergency?” and “Some good reasons to stay for your full treatment.”

We’ve also published the latest monthly informational flyer/poster for patients, on “Some Tips to Tame Your Temper.”  Find it at https://www.nwrn.org/patients-a-family/ptedres/mon.html .

AAKP Healthline 2/17 re Protein in Urine

On February 17, 2015, AAKP will present a Healthline webinar and conference call, for patients with CKD or residual function, on The Importance of Understanding and Managing Protein in the Urine, aka proteinuria.  For details see https://www.aakp.org/community/programs-events/aakp-healthline.html .

Dementia & Missed/Shortened Treatments

NIH has published an abstract of an article called “Longer Dialysis Times Are Associated With a Lower Chance of Dementia Among Chronic Hemodialysis Patients” on its PubMed website at http://www.ncbi.nlm.nih.gov/pubmed/25196986.  We’ve added the link to our Missed Treatments Learning and Action Network page at http://www.nwrenalnetwork.org/QI/LAN/LAN.htm#miss.

Dialysis Adequacy Resources

We’ve added new resources to the Missed Treatments section of our Learning and Action Network web page, including a root cause form for patient adherence, and Module 10 on Getting Adequate Dialysis from the Medical Education Institute’s Kidney School.  The latter is available in printed, online, audio, and Spanish versions.  Find them all at http://www.nwrenalnetwork.org/QI/LAN/LAN.htm#miss.

Patient Poster – Early Exits

Northwest Renal Network’s monthly patient flyer is now posted on our website at http://www.nwrenalnetwork.org/P/M/Monthly.htm.  The featured topic for March is Just A Minute… – on not shaving time off of your dialysis treatments.  These flyers are designed for posting in the facility waiting area, and for distribution to patients and family members.  Contact our Patient Services Director, Lisa Hall (lhall@nw16.esrd.net) if you have questions or ideas for future monthly topics.