Home dialysis basics

Five New Year’s resolutions every home dialysis patient should make

By Amy Rose, R.N.

January is the perfect time for every dialysis patient to make five New Year’s resolutions that will result in a healthier 2008.

Eat right

A renal diet can help control the buildup of waste products and fluid in your blood. The main goals of a renal diet are to keep you from building up too many toxins and too much fluid between dialysis treatments. In general, this diet focuses on reducing protein, phosphorus, potassium and salt intake. Depending on the type of dialysis treatment you perform and your lab results, you may be able to include certain foods in your diet. Make sure to consult your renal dietitian for specific instructions about your dietary needs. Most importantly, do your best to take your phosphorus binders every time you eat.

Some good dietary choices are:

• White bread
• Unsweetened, refined dry cereals
• Cream of Wheat
• Noodles
• Pasta
• Rice
• Fruit canned
• Lean meat
• Poultry
• Fish
• Eggs
• Low-sodium cottage cheese
• Margarine (low in trans fat)
• Low-fat cream cheese

Some dietary choices to avoid are:

• Chocolate milk
• Whole wheat bread
• Whole wheat cereals
• Pancake mix
• Cornbread mix
• Salted snacks like corn chips or potato chips
• Tomato sauce
• Vegetable juice
• Bacon
• Luncheon meats
• Hot dogs
• Pepperoni

Exercise

No matter what your situation, you can exercise. Getting in motion, even if it’s only for a short time everyday, will help you to feel better, stronger and more in control of your life. Always remember to discuss exercise with your nephrologist and let him or her know if you are having difficulty.

Some recommendations for beginners are:  (Aim for 15-20 minutes)

• Point and flex your toes
• Roll shoulders forward and backward
• Lift your arms up high
• Tilt head from side to side
• Touch your toes

Some recommendations for intermediates are: (Aim for 20-30 minutes)

• Walk up a flight of stairs
• Park car farther away from store or house
• Go for a walk
• Rake leaves
• Clean out a closet
• Mop or sweep a floor

Stop smoking

If you smoke, stop. Many studies have shown that it is a very unhealthy habit to have, but smoking is extremely dangerous to dialysis patients because of your delicate vascular system. Your arteries are like a rubber band. They expand and contract drastically each time you smoke or are around passive smoke. Many dialysis patients have hardening and calcification of the arteries due to rapid weight gains and losses and poor phosphorus control. When you smoke and your arteries cannot expand and contract, it causes a temporary rise and lowering of your blood pressure. This, in turn, causes stress on your heart. The stress on your heart may be manifested as chest pain, shortness of breath, heart attack and/or stroke. There is no time like the present to kick the habit.

Learn more about your health condition

Kidney disease is one of the most overlooked and under scrutinized diseases. Did you know that there are actually five functions that your kidneys perform? Kidneys remove fluid, remove waste, produce renin, maintain calcium/phosphorus balance and produce erythropoietin. If these concepts are unfamiliar to you, get out your old training manual and review the functions of the kidney. If you cannot locate your training manual, contact your local home hemodialysis nurse. People who are well-educated about their health condition and involved in their care often have better clinical outcomes.

Have fun

Having fun is a great way to get out of the house and help avoid depression. There are many activities you can do or ways to give back to the community, no matter your skill or ability level. The possibilities are endless.

Here are some suggestions:

• Enroll in a cooking class
• Take a vacation
• Join an online dialysis message board
• Check out DaVita’s Patient Citizens on www.dialysispatients.org
• Have a poker night with friends
• Learn to play a musical instrument
• Help your center plan a patient party
• Become a Village Greeter for dialysis patients at a DaVita center
• Take up sewing
• Enroll in an art class to learn scrap booking or painting
• Bird watching
• Learn to fish
• Offer to baby-sit for a relative or friend
• Coin collecting
• Join a YMCA

Summary

This year, make it your resolution to eat right, exercise, stop smoking, learn about your health condition and have some fun. You’ll be happy you did.

About Amy Rose

Amy Rose is a home hemodialysis training nurse at White Oak DaVita at Home in Cincinnati, OH, whose goal is to improve the quality of life for her patients. She is married and has one daughter.

Related articles on DaVita.com

• Home dialysis and your diet
• Smoking and chronic kidney disease (CKD)