Life with dialysis

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.

Care coordinator
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.

HDF Online
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.