The dialysis fact sheet is intended for Diapriva dialysis patients, but also for their family members and other interested parties. By means of the dialysis fact sheet, we would like to inform you of the day-to-day affairs at Diapriva. We recommend that you read through this document Diapriva fact sheet at your convenience. In this way we hope to answer a number of questions and remove any doubts.
Lead a normal life wherever possible
There are approximately 60 thousand people in the Netherlands with some degree of kidney damage, ranging from a milder to a more severe form. Over time many of them become reliant on dialysis treatment. What does that mean? How does dialysis work and what is your daily life like when you undergo dialysis? Below you will read exactly how Diapriva is working to keep your life as pleasant as possible and is trying to fit into the life to which you are accustomed.
For the dialysis
If your kidney function drops below 10%, your kidneys need help. Dialysis can then ensure that you can go on with your life. There are then three possibilities: haemodialysis, peritoneal dialysis or transplantation. Approximately half of the dialysis patients are on the transplant waiting list. The waiting time for a transplant is between four and five years. Until that time, there is haemodialysis, which is performed at a centre such as Diapriva, and there is peritoneal dialysis, which you yourself perform at home. Some patients continue to depend on dialysis. In unique cases, in which the choice is made for the patient’s quality of life, the decision is made to discontinue dialysis. In that case you will be assisted in the most dignified manner possible, for example with the removal of fluid and with other assistance.
For persistent kidney complaints, the nephrologist (the kidney doctor, the internist that specialises in kidneys) often refers the patient for haemodialysis at a centre such as Diapriva. In haemodialysis, blood is filtered through an artificial kidney. We first provide the patients that we have the privilege of welcoming a tour and we then look at which dialysis schedule would best suit the patient. We take this schedule very seriously. If you are attached to a machine three times per week for four or five hours, it has a considerable impact on your life. We try to find a way to enable you to continue leading as normal a life as possible. We often do that in cooperation with social services.
Starting with the treatment
If you are to receive treatment here, many practical matters are handled in advance, such as transport. Some patients have their own means of transport, but in most instances a taxi is the best solution. The secretariat will then contact the health insurance company, which arranges a taxi for you. The rest is also arranged. The first few times in particular the treatment seems complicated. You are faced with balanced medication, with machines that you are unfamiliar with and with a computer system that analyses your treatment. What is reassuring is that you then regularly get to see your own nephrologist in the ward. This document, along with the nursing staff, will ensure that your treatment is put on the right track.
Every patient that we receive here gets his/her own nurse, who will come and sit with you during your first several visits to ensure that all of your questions are answered. This nurse will also go through a questionnaire (medical history) with you. Using your responses a plan of approach is prepared that is precisely tailored to your situation. This so-called nursing plan also takes into account special diets for example for diabetes patients. You can observe everything and in that way you can keep a watchful eye on things. Family members can also do that, but only if you grant your express permission for them to do so.
The actual dialysis
During dialysis 250 to 400 ml of blood per minute is cleansed. As you can see, the process is very fast. All of this is done by inserting what is known as a shunt. A normal blood vessel is not suitable for this, because they are easily damaged. A normal blood vessel is also too small, as a result of which the amount of blood that can be transported is inadequate. A shunt makes it possible to connect a dialysis machine to the patient’s blood stream, as a result of which approximately forty to sixty litres of blood can flow through in about four hours. Our nurses are highly proficient at inserting this type of shunt, which means that you experience very little discomfort from the shunt. Some patients must overcome their fear of needles, but the knowledge that the shunt is a lifeline helps them overcome that fear.
During the dialysis
The centre is open to all friends and family that you would like to have visit you during the treatment. That often makes the treatment a bit more pleasant. After all you will be sitting for a several hours a few times a week in a comfortable chair in which you can sleep, read, watch television of listen to the radio, make telephone calls and use the Internet or, for example, go through your work. During that time, you will be given something to drink or to eat twice. It can be a snack, a sandwich or a hot meal. Our kitchen assistants will prepare something that fits entirely within your nursing plan.
The daily routine
At the start of every treatment, you are weighed, for which you will use your personal key. This key, a type of memory stick, holds your personal identification, so that your location can be registered in the computer. Next you will go to your own locker in which you can place your own blanket, slippers, clips and so on. Then, you take a seat in the waiting room, where you will be picked up when your chair in the ward is ready. Once you are seated in your chair, a nurse will connect you to the dialysis machine which has been programmed with the treatment plan that has been worked out for you. Another nurse will carry out another check to ensure that any errors can immediately be corrected. Then the dialysis begins. Once the procedure is completed the needles are removed and pressure will be placed on the shunt for a few minutes until the bleeding has stopped. Next, your blood pressure will be measured and you walk over to the scale to see whether the target weight has been achieved. Then the procedure is complete and you wait for the taxi. Immediately after the dialysis you often still feel a bit fatigued, but you are often completely refreshed the next day.
Daytime or nocturnal dialysis?
Many people enjoy sleeping in their own bed. For many others, particularly patients who work during the day, nocturnal dialysis is often a good solution. With nocturnal dialysis you are connected at night between 9 p.m. and midnight, and you are then disconnected the next day, between 5 a.m. and 8 a.m. In the meantime you can enjoy a restful night’s sleep The nocturnal dialysis proceeds somewhat more gradually than the daytime dialysis, as a result of which the patient often immediately feels more refreshed during the day, particularly if you have slept soundly in the meantime. You have your own room and each patient is given clean sheets, a private toilet, shower, television and Internet connection. The light can be turned off whenever you wish. No blood pressure monitoring is carried out during the night and there is a central monitoring post. This monitoring post is staffed by nurses who monitor the dialysis machines remotely. There is no camera supervision, which means that you have all of the privacy that you wish.
In recent years many doctors have started to prescribe a new treatment, the so-called Nocturnal HD treatment. Patients who experience restless leg syndrome (RLS) or other complications can be helped using this relatively new form of treatment. This treatment is also available at Diapriva.
There are a great many options available to increase your sense of freedom as much as possible. We work together with you to locate dialysis centres abroad if you wish to go on holiday. There are also various options available for a long-term stay abroad, for example in Surinam. If the patient is medically stable, there are many options available.
Medical social work at Diapriva
If you have a kidney disease, and must undergo dialysis treatment to deal with the disorder, you can also experience problems in your personal life, in addition to your physical complaints. These problems can be psychological, relational, social or societal in nature and can be a source of stress. The medical social work at Diapriva focuses on reducing these sources of stress and increasing sources of strength.
Each new patient at Diapriva has a meeting with a medical social worker. During this meeting you get to know the medical social worker better. During the meeting the medical social worker also provides you information and an explanation of the services on offer and the working methods of the medical social work at Diapriva. The basic principle during the meeting with the medical social worker is that the conversations focus on maintaining (and if possible increasing) your independence, during which your personal need(s) are taken into account wherever possible. If desirable (and possible), we will involve the people around you in the provision of assistance.
Psychosocial help and practical/material assistance
The assistance – and the services provided by the medical social workers – can be divided into psychosocial assistance and practical/materiel assistance and consists (among other things) of:
- Counselling in processing and accepting your kidney disease and the resulting changes to your daily life;
- Support when processing bad news;
- Coaching in learning to deal with the various emotions that your kidney disease/treatment can trigger in you;
- Providing information, advice and if required mediation in the practical consequences of your kidney disease/treatment;
- Helping you come into contact with various agencies.
Examples of questions for which you can turn to Diapriva’s department of medical social work are:
- How do I deal with the feelings that my disease/treatment trigger in me (for example: disbelief, dependence, fear or uncertainty)?
- How do I fit the dialysis treatment into my life?
- What arrangements and facilities can I make use of?
- Who can I turn to if my problems require a more specialist approach?
The medical social worker is bound by a duty of confidentiality.
You can contact the Diapriva’s department of medical social work through the doctor or nurse, or by calling Diapriva’s general telephone number.
Nutrition is important to everyone, providing energy and nutrients and contributing to your physical fitness. Nutrition is of added importance during a dialysis treatment, because you require extra nutrients or because eating more moderate portions is better for you. Diapriva has a dietician who can counsel you and who you of course can contact with your questions or for information relating to diet during haemodialysis.
Advice and tips
The dietician at Diapriva is an expert in the area of nutrition and kidney diseases. The treatment offered by the dietician focuses on nutrition, but recent laboratory values, and medication use, are also looked in order to offer you advice that is as effective and comprehensive as possible. Some people think that the dietician will tell you there are all kinds of things you cannot consume, but nothing is further from the truth! During meetings the dietician will look at options that fit into your diet and the dietician can help you make the right choices. Everyone has different wishes and needs, and for this reason the dietician looks at what a suitable eating pattern is for each individual.
An important part of the nutritional treatment is that the dietician looks at your nutritional status. The dialysis treatment and medicine use can make you to feel less fit and to experience complaints such as nausea, which in turn affects your appetite. As a result, you might eat less than you require, which can lead to a deficiency in nutrients. This in turn leads to deterioration in your physical condition and a breakdown in muscle mass. Together with you the dietician will regularly look at your nutritional status and agree treatment goals with you to ensure that your muscle mass and physical condition remain at the best possible level.
Soon after you start dialysis treatment at Diapriva the dietician will pay you a visit. If you have questions, you can contact the dietician by telephone on +31(0)20-301 1950 or by e-mail at firstname.lastname@example.org.
In all insurers have contracts for day dialysis and night dialysis for the year 2017.
|daytime dialysis||nocturnal dialysis|
|Zilveren Kruis Achmea
(Also Self Care Dialysis)
|Eno; Salland Zorgverzekeringen UA||yes||yes|
|Zorg en Zekerheid||yes||yes|
|CZ GRT/Z (CZ Groep Zorgverz)||yes||yes|
|NV Univé Zorg||yes||yes|
|IZA Zorgverzekering NV||yes||yes|
|Menzis Zorgverzekeraar U.A.||yes||yes|