Home dialysis basics

10 New Year’s resolutions for home dialysis patients

Written by Amy Rose, RN, DaVita Nurse

As a home dialysis patient you may have hunkered down and stuck to your New Year’s resolutions you made last year, right? Well, if you didn’t stick to those resolutions, here are 10 that every home dialysis patient should consider to get you started on the right foot:

1. Follow your dialysis diet

A dialysis or renal diet can help control the buildup of waste products, toxins and fluid in your blood between dialysis treatments. 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 appropriate amounts of protein, phosphorus, potassium and salt intake. Depending on whether you do home hemodialysis or peritoneal dialysis and your lab results, you may be able to include certain foods in your diet that people doing in-center hemodialysis need to limit or avoid. Make sure to consult your renal dietitian for specific instructions about your dietary needs. Also, do your best to take your phosphorus binders every time you eat.

Some good dialysis diet food choices are:

Foods that are recommended on the dialysis diet are low in phosphorus, potassium and sodium. Some good foods for a dialysis diet include:

Lean meat
Poultry
Fish
Eggs
White bread
Cream of Wheat®
Noodles
Pasta
Rice
Canned fruit
Margarine (no trans fat)
Low-fat cream cheese

Some foods to avoid on the dialysis diet:

Some foods are naturally high in phosphorus and potassium, but both electrolytes can also be added to processed foods can contain hidden sodium, phosphorus and potassium. Be sure to read labels for nutrition content and ingredients to make the best choices and ask your renal dietitian for a list of foods to limit or avoid. Some foods high in phosphorus, potassium or sodium include:

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

2. Exercise even though you’re on dialysis

No matter what your situation, you can exercise. Getting in motion, even if it’s only for a short time everyday, will help you 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.

Exercise 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

Exercise 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

3. Try new kidney-friendly recipes

Eating right on the dialysis diet doesn’t have to be boring and you don’t have to eat the same old thing all the time. Be more adventurous with food and try new, delicious and kidney-friendly recipes. DaVita.com has hundreds of recipes that have been submitted by DaVita renal dietitians. If you eat the proper portion of these recipes, you will be staying within the recommended limits for phosphorus, potassium and sodium per meal. Here is a list of some recipes for breakfast, appetizers, lunch and dinner:

Breakfast

Appetizers

Lunch or Dinner

In addition to renal-friendly recipes, DaVita.com also has an online meal planning tool called the DaVita Diet Helper. It will help you plan, prepare and track kidney-friendly meals.

4. Stop smoking

If you smoke, stop. Many studies have shown that it is an unhealthy habit and smoking is especially dangerous to dialysis patients because of their delicate vascular systems. 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 cause you chest pain, shortness of breath, heart attack and/or stroke.

Smoking also contributes to a number of cancers including lung cancer. The mixture of nicotine and carbon monoxide in each cigarette you smoke temporarily increases your heart rate and blood pressure, straining your heart and blood vessels. This can also cause heart attacks and strokes. Carbon monoxide binds to hemoglobin in red blood cells, preventing these cells from carrying a full load of oxygen to the body’s tissues. And smoking affects the function of the immune system and may increase the risk for respiratory and other infections. With these harmful effects in mind, there is no time like the present to kick the habit.

5. Learn more about kidney disease and dialysis

Kidney disease is one of the most overlooked and under scrutinized diseases. Did you know that your kidneys perform several functions? Many people know that kidneys remove fluid and waste that are removed from the body through urine, but did you know kidneys also produce renin that controls blood pressure, maintain calcium and phosphorus balance and produce erythropoietin that signals the bones to make red blood cells? If these concepts are unfamiliar to you, you can find great information online that explains the functions of the kidney. You can also 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.

6. Be safe performing your dialysis treatments

As a home dialysis patient, you want to make sure that safety is priority. All home dialysis patients (along with caregivers, if you have one) are trained to administer dialysis treatment. Make sure you continue to keep a clean environment for home dialysis, be adaptable to any new training needed, and keep regular monthly visits with your doctor, home training nurse, renal dietitian, social worker and other members of your medical team.

7. Support your home dialysis care partner

Your home dialysis care partner can do so much more than just help you administer dialysis. They sometimes take on other things such as running your errands, cooking your dinners, taking you to your appointments, cleaning your house and giving you continued support. Usually care partners are a family member or spouse who are going above and beyond the expectations of a regular family member in the household. Your care partner does so much for you that you may want to give back. Here are some ways to show your support throughout the year and beyond:

Say thank you, verbally or with a note
Offer to cook once in a while, or order take-out
Help clean part of the house when you can
Get them a gift or make them something special
Take them out to a movie, ball game or comedy show
Have fun by throwing a dinner party, playing cards, sharing jokes or enjoying a picnic
Give them space to do their own activities and have a family member or friend help you around the house while your care partner is away

8. Make an “Important Phone Numbers” list

When something unexpected happens, you want to make sure you have the most important phone numbers readily available. Your “Important Phone Numbers” list can include contact information for your doctor, home dialysis care partner, dialysis provider, insurer, family members and friends. Post your list in a visible area such as on your refrigerator, in a phone book, on your nightstand or any other place that can be accessed easily. You may want to make multiple copies in case a list disappears. You can also save the phone numbers in a Word document to your computer, email them to yourself or save them in your cellular phone.

9. Build a home dialysis support network

A home dialysis support network can be comprised of many different people. Your home dialysis care provider, family, friends, online forum group (check out the DaVita.com Discussion Forum) and nephrologists are part of your team. A support network is important to have because it can help increase your energy (go out to dinner with friends), build your knowledge of the disease (ask others questions online), regain a social life (someone to chat with) and show better clinical outcomes (positive thinking and activities is said to improve health for some) after a doctor’s visit.

10. Have fun

Having fun is a great way to get out of the house and help avoid depression. Enjoy your favorite activities or get together with your favorite friends. Helping others also brings a sense of well-being and can be fun. There are many ways to give back to the community, no matter your skill or ability level. The possibilities are endless.

Some suggestions for having fun:

Enroll in a cooking class
Take a vacation
Join an online dialysis message board
Check out Dialysis Patient Citizens on www.dialysispatients.org
Have a poker night with friends
Learn to play a musical instrument
Help your dialysis 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
Volunteer to share your experience with other patients who may be interested in learning more about home dialysis
Offer to baby-sit for a relative or friend
Coin collecting
Join a YMCA