Living Donation

Source: National Kidney Foundation

You can consider being a living kidney donor. Living donation takes place when a living person donates an organ or part of an organ to someone in need of a transplant. The donor is most often a close family member, such as a parent, child, brother or sister. A donor can also be a more distant family member, spouse, friend or co-worker.

General Information on Living Donation

What is living donation?
Living donation takes place when a living person donates an organ (or part of an organ) for transplantation to another person. The living donor can be a family member, such as a parent, child, brother or sister (living related donation).

Living donation can also come from someone who is emotionally related to the recipient, such as a good friend, spouse or an in-law (living unrelated donation).

In some cases, living donation may even be from a stranger, which is called nondirected donation though that is not common in Nigeria

What organs can come from living donors?
The organ most commonly given by a living donor is the kidney. People usually have two kidneys, and one is all that is needed to live a normal life. Parts of other organs including the lung, liver and pancreas are now being transplanted from living donors.

What are the advantages of living donation over deceased donation?
Transplants performed from living donors have several advantages compared to transplants performed from deceased donors:

Some living donor transplants are done between family members who are genetically similar. A better genetic match lessens the risk of rejection.

A kidney from a living donor usually functions immediately, making it easier to monitor. Some deceased donor kidneys do not function immediately, and as a result, the patient may require dialysis until the kidney starts to function.

Potential donors can be tested ahead of time to find the donor who is most compatible with the recipient. The transplant can take place at a time convenient for both the donor and recipient.

Are transplants from living donors always successful?
Although transplantation is highly successful, and success rates continue to improve, problems may occur. Sometimes, the kidney is lost to rejection, surgical complications or the original disease that caused the recipient's kidney to fail. Talk to the transplant center staff about their success rates and the national success rates.

How can I be a living kidney donor to someone I know?
To donate a kidney, you must be in good health and have normal kidney function and anatomy.
If the donor meets the criteria for donation, additional testing will be required to check for further compatibility (cross matching and tissue typing) as well as physical examinations and psychological evaluation. More information on testing and surgery procedures can be found in this booklet.

The donor should make the decision voluntarily and free from internal or family pressure. The decision to donate needs to be made with all the information necessary to make an informed, educated choice.

Immunosuppressive medications, which keep the recipient's body from rejecting the donor kidney, have improved greatly over the last few years. Now, a genetic link between the donor and recipient does not appear to be necessary to ensure a successful transplant.

Before surgery, the donor will receive education and counseling to help prepare mentally and emotionally for the donation and recovery. If the donor has questions, the transplant team can help. The decision to donate will affect all members of the person's family and should not be taken lightly.

Your first step is to contact the potential recipient's transplant center. (Transplant centers are hospitals that perform transplant operations-and donor operations, if there is a living donor). You should ask to speak with the Kidney Transplant Coordinator, who can give you additional information about living donation, and help you get started. If you live far away from the transplant center, you'll be referred to a center in your area for initial testing.

I want to be a donor to a friend or family member, but they won't let me. What can I do?
Some individuals with kidney failure may decide they do not want the transplant or choose not to consider a living donor. The person with kidney failure can choose to accept or reject your offer to donate. He or she has the right to decide against a transplant (though you may feel it would help). The patient, who must live with the disease, has the right to decide what is to be done. That decision, as well as yours, must be respected.

What are the long-term risks of donation?
You will also have a scar from the donor operation- the size and location of the scar will depend on the type of operation you have.

Some donors have reported long-term problems with pain, nerve damage, hernia or intestinal obstruction.
There are not currently any national statistics on the frequency of these problems.

In addition, people with one kidney may be at a greater risk of:

• High blood pressure
• Proteinuria
• Reduced kidney function

You should discuss these risks with your transplant team, and ask for the hospital for any statistics related to these problems.

What else can I do?
You may not be able to be a living donor- or you may decide that living donation isn't right for you. You can still help those awaiting life-saving organ transplants and cannot afford the huge expense it entails by donating money to Nathan Kidney Foundation.

To fund our programs, we depend on contributions from caring individuals and corporate organizations. By making a gift today, you can give people living with kidney failure the gift of life.

Your donation can help:
• Inform people about how to prevent this epidemic and reduce fatalities
• Set up prevention programs in accessible health care centres
• Fund renal replacement therapies for the poor

Please make your donations through the following:

By cheque payable to the Nathan Kidney Foundation
23B, Ribadu Road, (1st Floor)
S/W Ikoyi,
Lagos State
For further information, please call us 01 – 8102805 or send an e-mail to donations@nkidneyfoundation.org

By payment into the following bank account:
Bank: GTBank
Account name: Nathan Kidney Foundation
Account number: 224 - 883641 - 110

By setting up a Standing Order with your bank This is an easy and manageable way to set up regular donations to NKF. Download, print, fill in and submit this form to your bank to set up a Standing Order.

Know More About Dialysis

Source: National Kidney Foundation


Dialysis
Dialysis is a treatment that does some of the things done by healthy kidneys. It is needed when your own kidneys can no longer take care of your body's needs.

When is dialysis needed?
You need dialysis when you develop end stage kidney failure --usually by the time you lose about 85 to 90 percent of your kidney function.

What does dialysis do?
Like healthy kidneys, dialysis keeps your body in balance. Dialysis does the following:

• removes waste, salt and extra water to prevent them from building up in the body
• keeps a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate
• helps to control blood pressure

Is kidney failure permanent?
Not always. Some kinds of acute kidney failure get better after treatment. In some cases of acute kidney failure, dialysis may only be needed for a short time until the kidneys get better.
In chronic or end stage kidney failure, your kidneys do not get better and you will need dialysis for the rest of your life. If your doctor says you are a candidate, you may choose to be placed on a waiting list for a new kidney.

Where is dialysis done?
Dialysis can be done in a hospital, in a dialysis unit that is not part of a hospital, or at home. You and your doctor will decide which place is best, based on your medical condition and your wishes.

Are there different types of dialysis?
Yes, there are two types of dialysis --hemodialysis and peritoneal dialysis.

What is hemodialysis?
In hemodialysis, an artificial kidney (hemodialyzer) is used to remove waste and extra chemicals and fluid from your blood. To get your blood into the artificial kidney, the doctor needs to make an access (entrance) into your blood vessels. This is done by minor surgery to your arm or leg.

Sometimes, an access is made by joining an artery to a vein under your skin to make a bigger blood vessel called a fistula.

However, if your blood vessels are not adequate for a fistula, the doctor may use a soft plastic tube to join an artery and a vein under your skin. This is called a graft.

Occasionally, an access is made by means of a narrow plastic tube, called a catheter, which is inserted into a large vein in your neck. This type of access may be temporary, but is sometimes used for long-term treatment.

How long do hemodialysis treatments last?
The time needed for your dialysis depends on:

• how well your kidneys work
• how much fluid weight you gain between treatments
• how much waste you have in your body
• how big you are
• the type of artificial kidney used

Usually, each hemodialysis treatment lasts about four hours and is done three times per week.

A type of hemodialysis called high-flux dialysis may take less time. You can speak to your doctor to see if this is an appropriate treatment for you.

What is peritoneal dialysis and how does it work?
In this type of dialysis, your blood is cleaned inside your body. The doctor will do surgery to place a plastic tube called a catheter into your abdomen (belly) to make an access. During the treatment, your abdominal area (called the peritoneal cavity) is slowly filled with dialysate through the catheter. The blood stays in the arteries and veins that line your peritoneal cavity. Extra fluid and waste products are drawn out of your blood and into the dialysate. There are two major kinds of peritoneal dialysis.

What are the different kinds of peritoneal dialysis and how do they work?
There are several kinds of peritoneal dialysis but two major ones are:
Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cycling Peritoneal Dialysis (CCPD).

Continuous Ambulatory Peritoneal Dialysis (CAPD) is the only type of peritoneal dialysis that is done without machines. You do this yourself, usually four or five times a day at home and/or at work. You put a bag of dialysate (about two quarts) into your peritoneal cavity through the catheter. The dialysate stays there for about four or five hours before it is drained back into the bag and thrown away. This is called an exchange. You use a new bag of dialysate each time you do an exchange. While the dialysate is in your peritoneal cavity, you can go about your usual activities at work, at school or at home.

Continuous Cycling Peritoneal Dialysis (CCPD) usually is done at home using a special machine called a cycler. This is similar to CAPD except that a number of cycles (exchanges) occur. Each cycle usually lasts 1-1/2 hours and exchanges are done throughout the night while you sleep.

Will dialysis help cure the kidney disease?
No. Dialysis does some of the work of healthy kidneys, but it does not cure your kidney disease. You will need to have dialysis treatments for your whole life unless you are able to get a kidney transplant.

Is dialysis uncomfortable?
You may have some discomfort when the needles are put into your fistula or graft, but most patients have no other problems. The dialysis treatment itself is painless. However, some patients may have a drop in their blood pressure. If this happens, you may feel sick to your stomach, vomit, have a headache or cramps. With frequent treatments, those problems usually go away.

How long has dialysis been available?
Hemodialysis and peritoneal dialysis have been done since the mid 1940's. Dialysis, as a regular treatment, was begun in 1960 and is now a standard treatment all around the world. CAPD began in 1976. Thousands of patients have been helped by these treatments.

How long can you live on dialysis?
We do not yet know how long patients on dialysis will live. We think that some dialysis patients may live as long as people without kidney failure.

Is dialysis expensive?
Yes. Dialysis costs a lot of money. However, the federal government pays 80 percent of all dialysis costs for most patients. Private health insurance or state medical aid also help with the costs.

Do dialysis patients feel normal?
Many patients live normal lives except for the time needed for treatments. Dialysis usually makes you feel better because it helps many of the problems caused by kidney failure. You and your family will need time to get used to dialysis.

Do dialysis patients have to control their diets?
Yes. You may be on a special diet. You may not be able to eat everything you like, and you may need to limit how much you drink. Your diet may vary according to the type of dialysis.

Can dialysis Patients travel?
Yes. Dialysis centers are located in every part of the United States and in many foreign countries. The treatment is standardized. You must make an appointment for dialysis treatments at another center before you go. The staff at your center may help you make the appointment.

Can dialysis patients continue to work?
Many dialysis patients can go back to work after they have gotten used to dialysis. If your job has a lot of physical labor (heavy lifting, digging, etc. ), you may need to get a different job.

For further information, go to Nathan Kidney Foundation.

Sexuality and Chronic Kidney Disease

Source: National Kidney Foundation

Many people think that sexuality refers only to the act of sexual intercourse. Sexuality includes many factors, such as how people feel about themselves, how they communicate with others and how willing they are to build a relationship. In addition, sexuality involves a wide range of pleasurable sexual activities that may or may not include intercourse, such as touching, hugging and kissing. Being a sexual person is healthy. Lovemaking may provide a way of feeling "normal" for people who are chronically ill.

How can kidney disease affect sex life?

Kidney disease can cause physical and emotional changes that may affect your sex life. The chemical changes that occur in your body with kidney disease affect hormones, circulation, nerve function and energy level. These changes usually lower sexual interest and/or sexual ability. Physical changes may cause people with kidney disease to feel less attractive sexually. Many of the medicines used to treat high blood pressure may affect sexual functioning.

Use of steroids may cause weight gain, acne, and unwanted hair growth or loss. Surgical scars can cause patients to feel unattractive. Medical changes and changes in self-image may affect sexual interest and functioning.

Is sexual intercourse safe for kidney patients?

Patients and their partners may worry that sexual activity could cause the patient's death or harm the dialysis access or transplanted kidney. No limitations need to be placed on kidney patients sexually. If sexual activity does not place pressure or tension on the access site, it will not cause damage. After receiving a transplant, it is important to wait until the scar has begun to heal. Once the doctor says it is all right to resume sexual activity, there is no reason to worry about damaging the transplanted kidney. Fear can cause people to avoid sexual activity needlessly.

For some couples, sexual intercourse is not possible. Some may feel that sex is not as important as it once was. Activities such as touching, hugging, and kissing provide feelings of warmth and closeness even if intercourse is not involved. Professional sex therapists can recommend alternative methods.

Will a child's sexual development be affected by kidney failure?

This depends on the child's age when kidney failure occurs. Young children with kidney disease are usually smaller than other children their age. They are also slower to develop sexually. Children who are on dialysis probably will have slower growth and sexual development than children who have kidney transplants. If a teenager has kidney disease, sexual development may slow down or even stop. For example, teenage girls may not have periods. Changes due to kidney failure and treatment may make the teenager feel different from his or her friends. Parents should express their concerns about growth and sexual development to the doctor. Parents of a child or teenager who is ill must fight the impulse to protect their child from the pain of growing up. Self-worth, independence, and sexual identity are important for teenagers. Parents need to talk openly with their children about physical, emotional, and sexual issues. Support groups for children and teenagers with kidney disease can be helpful. Contact a renal social worker or the National Kidney Foundation to find out if support groups are available near you.

Can you get AIDS from a transplant and risk giving AIDS to your sex partners?

Kidneys for transplantation and blood transfusions are now routinely tested for the AIDS virus. The risk of getting AIDS from a transplant or transfusion in the last few years is very small. Therefore, the risk of giving AIDS to a sex partner is small as a result of a transplant. Most health departments and health clinics can do a simple confidential blood test for HIV. Until the results of this test are known, use of a condom lowers the risk of passing the AIDS virus to a sex partner. Practicing safe sex is important for everyone.

Can a kidney transplant from someone of the opposite sex affect me sexually?

No. The sex of the kidney donor has no physical effect on the recipient's ability to function sexually or on sexual preference (heterosexual, homosexual, or bisexual).

Do transplant patients have fewer sexual problems than dialysis patients?

Generally, transplant patients have fewer sexual problems than dialysis patients because they may have fewer physical problems that affect their sex life like fatigue or anemia. But, having a transplant does not make them less prone to sexual concerns. The level of interest in and ability to have sex varies with things like the quality of the relationship, age, stress level, and physical conditions.

Will sexual problems get worse the longer dialysis continues?

This depends on the person. Having kidney failure, like any other chronic diseases, means that the body is in a weaker overall state of health. However, as the body adjusts to the treatment, the kidney patient should feel better physically and emotionally, and interest in sex may return to its earlier level. It is important to be patient and allow time to get used to the kidney disease and treatment. Being flexible and having a positive attitude about yourself and about sex may lower the chances of having severe sexual problems.

Can you tell whether sexual problems are due to physical or emotional causes?

Yes. This requires a complete medical, psychological and sexual history of the patient and his/her partner. Medicines should be reviewed for sexual side effects and changed if possible. Blood tests should include hormone levels and blood sugar levels to check for diabetes. Men can be checked to see if nerve and blood supply to the penis are good and if they can have an erection. If no physical problem is found, an emotional cause must be considered.

What can be done if the problem is physical?

Several options are available for men whose penis will not get or stay hard (erection). Penile implant surgery places inflatable or semi-rigid rods into the penis. In some cases, surgery can improve blood flow to the penis. If the man does not want surgery, male hormones may be given. Oral and injectable medications can cause an erection. External suction devices can make the penis hard enough for intercourse, but they require time and hand strength. Doctors with special training in impotence can give information on all options as well as their advantages, disadvantages, and side effects.

Women patients usually have less vaginal wetness and may have pain during sexual activity. Lower hormone levels can cause vaginal dryness. Use of a water-soluble vaginal lubricant can lower or stop pain associated with intercourse. Do not use petroleum jelly because it can increase the risk of infection. Some women may be unable to have a climax or may need more time to get "turned on" because of loss of energy, hormone changes, or medications for high blood pressure. A change in blood pressure medicine or extra hormones may be needed. Your doctor can provide information on options.

What can be done if the problem is psychological?

Feeling worried, anxious and depressed is normal when faced with a serious loss such as kidney failure. These emotions can cause loss of energy and lower interest in many activities including sex. If a sexual problem does occur, embarrassment and guilt often follow. Fear that the problem will happen again may cause the person to shy away from sexual situations. Relaxation exercises can help to control these fears. Regular physical exercise and activity help keep the mind busy and can improve physical condition and body image. If sexual problems continue, sex therapy can help. Even if the problem is psychological, some of the treatment options mentioned for physical problems may be helpful.

Can sex therapy help?

Sex therapy deals with the sexual problems of couples and individuals. The first step in sex therapy may be sexual education for the individual or couple. The therapist may assign activities to be done at home. These include communication exercises, stress reduction activities, and practicing ways of improving skills in giving and receiving enjoyable touches. Sex therapy can help with problems such as low sexual interest, trouble in reaching climax or reaching climax too soon, pain during sexual activity, and erection difficulties. Therapy also can help a person work through the effects of chronic illness on sexual functioning.

A sex therapist can be a psychiatrist, psychologist, physician, or social worker. Look for someone who is licensed and who has advanced training and experience in sexuality and sexual problems. Charges vary and may be covered partly by insurance.

What can kidney patients do to help themselves?

Take an active role in learning about kidney disease and treatment. Follow the prescribed diet and fluid limits. Take all medications properly and tell the doctor of any side effects. Ask for an exercise program to help muscle tone, strength, and endurance. Your doctor and dietitian can suggest a weight gain or loss program, if needed. Lead a healthy lifestyle. Be aware of other things that could affect your sexual functioning, such as drinking too much alcohol and smoking.

©2010 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. 

Top 6 Tips for Parents of Children with Chronic Kidney Disease

Source: National Kidney Foundation

Having a child diagnosed with a chronic disease is life-altering and can present emotional, financial and practical challenges for parents. Connecting with others who have experienced similar situations can be very helpful. here is a list of the top six tips from parents of children with chronic kidney disease

1. Learn about the disease and its treatments
Learn as much about your child's disease and its treatment as you possibly can. And pass this information on to your child. You'd be surprised at how much even very young children can understand. And many times they will accept information more easily than an adult. Encourage your child to ask questions not only of you but of doctors, nurses and other health professionals. Many times, your child will ask questions you had not thought about or were afraid to ask because you thought they sounded "dumb."

Don't try to explain more than your child can understand, but don't lie and don't apologize for any treatments or procedures that have to be followed. Help your child understand that the doctors, nurses, social workers, dietitians, laboratory personnel and everyone else is on his or her side. They all want to help your child feel better, even if that means they have to do things that will cause some temporary pain or discomfort.

2. Actively participate in your child's care
Develop a spirit of mutual respect and cooperation with health professionals. Write out all the details of your child's medical history, including dates. This will make it easier for you each time you come in contact with a new doctor.
Try to be with your child as much as possible during treatments and any hospitalization that might be necessary. If you cannot be there, arrange for someone else to be present such as a grandparent, other relative, or close family friend. And make sure a favorite book, stuffed animal or special blanket is taken along.

If your child is not talking yet, it's a good idea to tape a note to his or her hospital bed or crib with helpful information for the staff, such as favorite foods, special toys or blankets, preferred time and method of taking medicines.

3. Help your child take control of the illness
Try to maintain a normal daily routine, even during hospitalization. Help your child understand about doctor's offices, hospitals, dialysis units and laboratories and how they are used. By helping your child understand the places that are filled with strange and frightening instruments and machines, you can help eliminate a lot of your child's fear.

Be creative in finding ways for your child to participate in his or her own care. Your child will feel much more in control if you provide as many opportunities to do so as you can.

4. Help your child to understand and accept diet restrictions
Even a child as young as 2 or 3 can understand about "diet" if it is explained simply. Often, the child will be more compliant with dietary restrictions than an adult will.

Have your child make a list of favorite foods and take him or her with you when you talk to the dietitian to see if these foods can be incorporated into the diet plan.

Whatever you do, don't ever use bribes or force your child to eat. These tactics rarely work and more often turn mealtime into a very unpleasant experience.

5. Don't let medicine time ruin your day
A matter-of-fact attitude is your best weapon in getting your child to take medication. Even very small children will swallow anything, no matter how distasteful, if they know they have no choice.

A good trick with babies and small children is to use syringes minus the needles to dispense the medication. Not only can you measure the medicine more accurately, but you can squirt the liquid directly in the child's mouth instead of having to deal with a teaspoon (associated with food) or a medicine cup.
The benefit to your child is in not having to smell the medicine.

Your child has no choice about whether or not to take prescribed medication, but you can offer a choice of when and where. And once the choice is made, make a schedule and stick to it. Unpleasantness is a lot easier to cope with if you know exactly when it is coming and don't procrastinate.

Sometimes medication must be given with meals, but don't give it at the table where your child eats. Find someplace not associated with food and eating, such as the living or family room while your child is distracted by a favorite TV show.

Another weapon you have at medicine time is plain, ordinary water. If your child is on a fluid-restricted diet, water may be one of the things he or she would like to have most, so reserve part of the day's fluid intake for a couple of swallows after medicine time.

6. Share your experience with others
Don't let yourself become isolated. Talk with the renal staff and with other families of children with kidney disease. Don't hesitate to ask relatives and friends for help. Chances are they want to, but don't know how, and are just waiting for you to ask. Sharing your experience will help you find ways to grow with it.

The Cost of an Illness

It is heartbreaking enough to be told you are suffering from a disease.

Added to that, is the fact that it would slowly drain your life away if you do not replace an organ of yours - namely the kidney - as soon as possible.

To cap it all, it will cost you millions to live and you barely have thousands.

What can you do?

That is the typical scenario for someone diagnosed with end stage renal disease, where quality of life can only be assured with a kidney transplant.

There is the will to live but your bank account says no.

Please prevent kidney failure by doing the following:
1. Keep fit and active.
2. Control your blood sugar level
3. Monitor your blood pressure
4. Reduce your salt intake
5. Do not smoke
6. Eat healthy and keep your weight in check
7. Do not take over the counter pills on a regular basis
8. Check your kidney function if you have one or more of the "high risk" factors listed below
9. See your doctor immediately you notice anything unusual
10. Do a urinalysis today

Are your kidneys OK?