dialysis
TRANSCRIPT
DIALYSIS
Dr Frank Edwin
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAUSES OF RENAL FAILURE
1048707 Diabetes1048707 Untreated high blood pressure1048707 Inflammation1048707 Heredity1048707 Chronic infection1048707 Obstruction1048707 Accidents
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
1Renal Failure Diagnosis Symptoms Anorexia Nausea Vomiting Oliguria
bull Precipitating factors
Signs Anaemia Hypertension Fluid Overload etc Biochemistry
ndash Bloodbull Urea gt7mmollbull Creatinine gt120umollbull Electrolytes Rising K+
ndash Creatinine Clearance (GFR ltlt120mll)ndash Urine Proteinuria
May be Acute or Chronic Acute ndash Reversible or Irreversible
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
2 Treatment Options
No Treatment Monitoring amp Predialysis
ndash Control symptomsndash Preserve Residual Renal Function
bull Control rising BP (Antihypertensives)
bull Control Renal Bone Disease (Ca2+ Vit D)
bull PreventTreat Anaemias (Erythropoietin Blood)
Dialysis Renal Transplantation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Dialysis Definition Artificial process that partially replaces renal
function Removes waste products from blood by
diffusion (toxin clearance) Removes excess water by ultrafiltration
(maintenance of fluid balance) Wastes and water pass into a special liquid ndash
dialysis fluid or dialysate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Haemodialysis (HD)Peritoneal Dialysis (PD)They work on similar principles
Movement of solute or water across a semipermeable membrane (dialysis membrane)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Diffusion
Movement of solute Across semipermeable membraneFrom region of high concentration to
one of low concentration
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Ultrafiltration
Made possible by osmosis Movement of water Across semipermeable membrane From low osmolality to high osmolality Osmolality ndash number of osmotically active
particles in a unit (litre) of solvent
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Selection for HDPD
Clinical conditionLifestylePatient competencehygiene (PD -
high risk of infection) Affordability Availability
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
The process of diffusion
1
2
Blood cells are too big to pass through the dialysis membrane but body wastes begin to diffuse (pass) into the dialysis solution
3
Diffusion is complete Body wastes have diffused through the membrane and now there are equal amounts of waste in both the blood and the dialysis solution
The process of ultrafiltration in PD 11
22
Blood cells are too big to pass through the semi-permeable membrane but water in the blood is drawn into the dialysis fluid by the glucose
3
Ultrafiltration is complete Water has been drawn through the peritoneum by the glucose in the dialysis fluid by the glucose in the dialysis fluid There is now extra water in the dialysis fluid which need to be changed
Haemodialysis Dialysis process occurs outside the
body in a machineThe dialysis membrane is an artificial
one DialyserThe dialyser removes the excess fluid
and wastes from the blood and returns the filtered blood to the body
Haemodialysis needs to be performed three times a week
Each session lasts 3-6 hrsThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Requirements for HD
Good access to patients circulationGood cardiovascular status (dramatic
changes in BP may occur)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Performing HD
HD may be carried out In a HD UnitAt a Minimal Care Self-Care CentreAt Home
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Unit Specially designed Renal Unit within a
hospital Patients must travel to the Unit 3x a week Patients are unable to move around while on
dialysis may chat read watch TV or eat Nursing staff prepare equipment insert the
needles and supervise the sessions
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAUSES OF RENAL FAILURE
1048707 Diabetes1048707 Untreated high blood pressure1048707 Inflammation1048707 Heredity1048707 Chronic infection1048707 Obstruction1048707 Accidents
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
1Renal Failure Diagnosis Symptoms Anorexia Nausea Vomiting Oliguria
bull Precipitating factors
Signs Anaemia Hypertension Fluid Overload etc Biochemistry
ndash Bloodbull Urea gt7mmollbull Creatinine gt120umollbull Electrolytes Rising K+
ndash Creatinine Clearance (GFR ltlt120mll)ndash Urine Proteinuria
May be Acute or Chronic Acute ndash Reversible or Irreversible
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
2 Treatment Options
No Treatment Monitoring amp Predialysis
ndash Control symptomsndash Preserve Residual Renal Function
bull Control rising BP (Antihypertensives)
bull Control Renal Bone Disease (Ca2+ Vit D)
bull PreventTreat Anaemias (Erythropoietin Blood)
Dialysis Renal Transplantation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Dialysis Definition Artificial process that partially replaces renal
function Removes waste products from blood by
diffusion (toxin clearance) Removes excess water by ultrafiltration
(maintenance of fluid balance) Wastes and water pass into a special liquid ndash
dialysis fluid or dialysate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Haemodialysis (HD)Peritoneal Dialysis (PD)They work on similar principles
Movement of solute or water across a semipermeable membrane (dialysis membrane)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Diffusion
Movement of solute Across semipermeable membraneFrom region of high concentration to
one of low concentration
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Ultrafiltration
Made possible by osmosis Movement of water Across semipermeable membrane From low osmolality to high osmolality Osmolality ndash number of osmotically active
particles in a unit (litre) of solvent
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Selection for HDPD
Clinical conditionLifestylePatient competencehygiene (PD -
high risk of infection) Affordability Availability
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
The process of diffusion
1
2
Blood cells are too big to pass through the dialysis membrane but body wastes begin to diffuse (pass) into the dialysis solution
3
Diffusion is complete Body wastes have diffused through the membrane and now there are equal amounts of waste in both the blood and the dialysis solution
The process of ultrafiltration in PD 11
22
Blood cells are too big to pass through the semi-permeable membrane but water in the blood is drawn into the dialysis fluid by the glucose
3
Ultrafiltration is complete Water has been drawn through the peritoneum by the glucose in the dialysis fluid by the glucose in the dialysis fluid There is now extra water in the dialysis fluid which need to be changed
Haemodialysis Dialysis process occurs outside the
body in a machineThe dialysis membrane is an artificial
one DialyserThe dialyser removes the excess fluid
and wastes from the blood and returns the filtered blood to the body
Haemodialysis needs to be performed three times a week
Each session lasts 3-6 hrsThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Requirements for HD
Good access to patients circulationGood cardiovascular status (dramatic
changes in BP may occur)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Performing HD
HD may be carried out In a HD UnitAt a Minimal Care Self-Care CentreAt Home
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Unit Specially designed Renal Unit within a
hospital Patients must travel to the Unit 3x a week Patients are unable to move around while on
dialysis may chat read watch TV or eat Nursing staff prepare equipment insert the
needles and supervise the sessions
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
1Renal Failure Diagnosis Symptoms Anorexia Nausea Vomiting Oliguria
bull Precipitating factors
Signs Anaemia Hypertension Fluid Overload etc Biochemistry
ndash Bloodbull Urea gt7mmollbull Creatinine gt120umollbull Electrolytes Rising K+
ndash Creatinine Clearance (GFR ltlt120mll)ndash Urine Proteinuria
May be Acute or Chronic Acute ndash Reversible or Irreversible
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
2 Treatment Options
No Treatment Monitoring amp Predialysis
ndash Control symptomsndash Preserve Residual Renal Function
bull Control rising BP (Antihypertensives)
bull Control Renal Bone Disease (Ca2+ Vit D)
bull PreventTreat Anaemias (Erythropoietin Blood)
Dialysis Renal Transplantation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Dialysis Definition Artificial process that partially replaces renal
function Removes waste products from blood by
diffusion (toxin clearance) Removes excess water by ultrafiltration
(maintenance of fluid balance) Wastes and water pass into a special liquid ndash
dialysis fluid or dialysate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Haemodialysis (HD)Peritoneal Dialysis (PD)They work on similar principles
Movement of solute or water across a semipermeable membrane (dialysis membrane)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Diffusion
Movement of solute Across semipermeable membraneFrom region of high concentration to
one of low concentration
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Ultrafiltration
Made possible by osmosis Movement of water Across semipermeable membrane From low osmolality to high osmolality Osmolality ndash number of osmotically active
particles in a unit (litre) of solvent
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Selection for HDPD
Clinical conditionLifestylePatient competencehygiene (PD -
high risk of infection) Affordability Availability
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
The process of diffusion
1
2
Blood cells are too big to pass through the dialysis membrane but body wastes begin to diffuse (pass) into the dialysis solution
3
Diffusion is complete Body wastes have diffused through the membrane and now there are equal amounts of waste in both the blood and the dialysis solution
The process of ultrafiltration in PD 11
22
Blood cells are too big to pass through the semi-permeable membrane but water in the blood is drawn into the dialysis fluid by the glucose
3
Ultrafiltration is complete Water has been drawn through the peritoneum by the glucose in the dialysis fluid by the glucose in the dialysis fluid There is now extra water in the dialysis fluid which need to be changed
Haemodialysis Dialysis process occurs outside the
body in a machineThe dialysis membrane is an artificial
one DialyserThe dialyser removes the excess fluid
and wastes from the blood and returns the filtered blood to the body
Haemodialysis needs to be performed three times a week
Each session lasts 3-6 hrsThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Requirements for HD
Good access to patients circulationGood cardiovascular status (dramatic
changes in BP may occur)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Performing HD
HD may be carried out In a HD UnitAt a Minimal Care Self-Care CentreAt Home
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Unit Specially designed Renal Unit within a
hospital Patients must travel to the Unit 3x a week Patients are unable to move around while on
dialysis may chat read watch TV or eat Nursing staff prepare equipment insert the
needles and supervise the sessions
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
2 Treatment Options
No Treatment Monitoring amp Predialysis
ndash Control symptomsndash Preserve Residual Renal Function
bull Control rising BP (Antihypertensives)
bull Control Renal Bone Disease (Ca2+ Vit D)
bull PreventTreat Anaemias (Erythropoietin Blood)
Dialysis Renal Transplantation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Dialysis Definition Artificial process that partially replaces renal
function Removes waste products from blood by
diffusion (toxin clearance) Removes excess water by ultrafiltration
(maintenance of fluid balance) Wastes and water pass into a special liquid ndash
dialysis fluid or dialysate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Haemodialysis (HD)Peritoneal Dialysis (PD)They work on similar principles
Movement of solute or water across a semipermeable membrane (dialysis membrane)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Diffusion
Movement of solute Across semipermeable membraneFrom region of high concentration to
one of low concentration
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Ultrafiltration
Made possible by osmosis Movement of water Across semipermeable membrane From low osmolality to high osmolality Osmolality ndash number of osmotically active
particles in a unit (litre) of solvent
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Selection for HDPD
Clinical conditionLifestylePatient competencehygiene (PD -
high risk of infection) Affordability Availability
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
The process of diffusion
1
2
Blood cells are too big to pass through the dialysis membrane but body wastes begin to diffuse (pass) into the dialysis solution
3
Diffusion is complete Body wastes have diffused through the membrane and now there are equal amounts of waste in both the blood and the dialysis solution
The process of ultrafiltration in PD 11
22
Blood cells are too big to pass through the semi-permeable membrane but water in the blood is drawn into the dialysis fluid by the glucose
3
Ultrafiltration is complete Water has been drawn through the peritoneum by the glucose in the dialysis fluid by the glucose in the dialysis fluid There is now extra water in the dialysis fluid which need to be changed
Haemodialysis Dialysis process occurs outside the
body in a machineThe dialysis membrane is an artificial
one DialyserThe dialyser removes the excess fluid
and wastes from the blood and returns the filtered blood to the body
Haemodialysis needs to be performed three times a week
Each session lasts 3-6 hrsThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Requirements for HD
Good access to patients circulationGood cardiovascular status (dramatic
changes in BP may occur)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Performing HD
HD may be carried out In a HD UnitAt a Minimal Care Self-Care CentreAt Home
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Unit Specially designed Renal Unit within a
hospital Patients must travel to the Unit 3x a week Patients are unable to move around while on
dialysis may chat read watch TV or eat Nursing staff prepare equipment insert the
needles and supervise the sessions
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Dialysis Definition Artificial process that partially replaces renal
function Removes waste products from blood by
diffusion (toxin clearance) Removes excess water by ultrafiltration
(maintenance of fluid balance) Wastes and water pass into a special liquid ndash
dialysis fluid or dialysate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Haemodialysis (HD)Peritoneal Dialysis (PD)They work on similar principles
Movement of solute or water across a semipermeable membrane (dialysis membrane)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Diffusion
Movement of solute Across semipermeable membraneFrom region of high concentration to
one of low concentration
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Ultrafiltration
Made possible by osmosis Movement of water Across semipermeable membrane From low osmolality to high osmolality Osmolality ndash number of osmotically active
particles in a unit (litre) of solvent
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Selection for HDPD
Clinical conditionLifestylePatient competencehygiene (PD -
high risk of infection) Affordability Availability
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
The process of diffusion
1
2
Blood cells are too big to pass through the dialysis membrane but body wastes begin to diffuse (pass) into the dialysis solution
3
Diffusion is complete Body wastes have diffused through the membrane and now there are equal amounts of waste in both the blood and the dialysis solution
The process of ultrafiltration in PD 11
22
Blood cells are too big to pass through the semi-permeable membrane but water in the blood is drawn into the dialysis fluid by the glucose
3
Ultrafiltration is complete Water has been drawn through the peritoneum by the glucose in the dialysis fluid by the glucose in the dialysis fluid There is now extra water in the dialysis fluid which need to be changed
Haemodialysis Dialysis process occurs outside the
body in a machineThe dialysis membrane is an artificial
one DialyserThe dialyser removes the excess fluid
and wastes from the blood and returns the filtered blood to the body
Haemodialysis needs to be performed three times a week
Each session lasts 3-6 hrsThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Requirements for HD
Good access to patients circulationGood cardiovascular status (dramatic
changes in BP may occur)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Performing HD
HD may be carried out In a HD UnitAt a Minimal Care Self-Care CentreAt Home
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Unit Specially designed Renal Unit within a
hospital Patients must travel to the Unit 3x a week Patients are unable to move around while on
dialysis may chat read watch TV or eat Nursing staff prepare equipment insert the
needles and supervise the sessions
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Haemodialysis (HD)Peritoneal Dialysis (PD)They work on similar principles
Movement of solute or water across a semipermeable membrane (dialysis membrane)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Diffusion
Movement of solute Across semipermeable membraneFrom region of high concentration to
one of low concentration
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Ultrafiltration
Made possible by osmosis Movement of water Across semipermeable membrane From low osmolality to high osmolality Osmolality ndash number of osmotically active
particles in a unit (litre) of solvent
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Selection for HDPD
Clinical conditionLifestylePatient competencehygiene (PD -
high risk of infection) Affordability Availability
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
The process of diffusion
1
2
Blood cells are too big to pass through the dialysis membrane but body wastes begin to diffuse (pass) into the dialysis solution
3
Diffusion is complete Body wastes have diffused through the membrane and now there are equal amounts of waste in both the blood and the dialysis solution
The process of ultrafiltration in PD 11
22
Blood cells are too big to pass through the semi-permeable membrane but water in the blood is drawn into the dialysis fluid by the glucose
3
Ultrafiltration is complete Water has been drawn through the peritoneum by the glucose in the dialysis fluid by the glucose in the dialysis fluid There is now extra water in the dialysis fluid which need to be changed
Haemodialysis Dialysis process occurs outside the
body in a machineThe dialysis membrane is an artificial
one DialyserThe dialyser removes the excess fluid
and wastes from the blood and returns the filtered blood to the body
Haemodialysis needs to be performed three times a week
Each session lasts 3-6 hrsThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Requirements for HD
Good access to patients circulationGood cardiovascular status (dramatic
changes in BP may occur)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Performing HD
HD may be carried out In a HD UnitAt a Minimal Care Self-Care CentreAt Home
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Unit Specially designed Renal Unit within a
hospital Patients must travel to the Unit 3x a week Patients are unable to move around while on
dialysis may chat read watch TV or eat Nursing staff prepare equipment insert the
needles and supervise the sessions
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Diffusion
Movement of solute Across semipermeable membraneFrom region of high concentration to
one of low concentration
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Ultrafiltration
Made possible by osmosis Movement of water Across semipermeable membrane From low osmolality to high osmolality Osmolality ndash number of osmotically active
particles in a unit (litre) of solvent
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Selection for HDPD
Clinical conditionLifestylePatient competencehygiene (PD -
high risk of infection) Affordability Availability
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
The process of diffusion
1
2
Blood cells are too big to pass through the dialysis membrane but body wastes begin to diffuse (pass) into the dialysis solution
3
Diffusion is complete Body wastes have diffused through the membrane and now there are equal amounts of waste in both the blood and the dialysis solution
The process of ultrafiltration in PD 11
22
Blood cells are too big to pass through the semi-permeable membrane but water in the blood is drawn into the dialysis fluid by the glucose
3
Ultrafiltration is complete Water has been drawn through the peritoneum by the glucose in the dialysis fluid by the glucose in the dialysis fluid There is now extra water in the dialysis fluid which need to be changed
Haemodialysis Dialysis process occurs outside the
body in a machineThe dialysis membrane is an artificial
one DialyserThe dialyser removes the excess fluid
and wastes from the blood and returns the filtered blood to the body
Haemodialysis needs to be performed three times a week
Each session lasts 3-6 hrsThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Requirements for HD
Good access to patients circulationGood cardiovascular status (dramatic
changes in BP may occur)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Performing HD
HD may be carried out In a HD UnitAt a Minimal Care Self-Care CentreAt Home
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Unit Specially designed Renal Unit within a
hospital Patients must travel to the Unit 3x a week Patients are unable to move around while on
dialysis may chat read watch TV or eat Nursing staff prepare equipment insert the
needles and supervise the sessions
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Ultrafiltration
Made possible by osmosis Movement of water Across semipermeable membrane From low osmolality to high osmolality Osmolality ndash number of osmotically active
particles in a unit (litre) of solvent
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Selection for HDPD
Clinical conditionLifestylePatient competencehygiene (PD -
high risk of infection) Affordability Availability
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
The process of diffusion
1
2
Blood cells are too big to pass through the dialysis membrane but body wastes begin to diffuse (pass) into the dialysis solution
3
Diffusion is complete Body wastes have diffused through the membrane and now there are equal amounts of waste in both the blood and the dialysis solution
The process of ultrafiltration in PD 11
22
Blood cells are too big to pass through the semi-permeable membrane but water in the blood is drawn into the dialysis fluid by the glucose
3
Ultrafiltration is complete Water has been drawn through the peritoneum by the glucose in the dialysis fluid by the glucose in the dialysis fluid There is now extra water in the dialysis fluid which need to be changed
Haemodialysis Dialysis process occurs outside the
body in a machineThe dialysis membrane is an artificial
one DialyserThe dialyser removes the excess fluid
and wastes from the blood and returns the filtered blood to the body
Haemodialysis needs to be performed three times a week
Each session lasts 3-6 hrsThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Requirements for HD
Good access to patients circulationGood cardiovascular status (dramatic
changes in BP may occur)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Performing HD
HD may be carried out In a HD UnitAt a Minimal Care Self-Care CentreAt Home
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Unit Specially designed Renal Unit within a
hospital Patients must travel to the Unit 3x a week Patients are unable to move around while on
dialysis may chat read watch TV or eat Nursing staff prepare equipment insert the
needles and supervise the sessions
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Selection for HDPD
Clinical conditionLifestylePatient competencehygiene (PD -
high risk of infection) Affordability Availability
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
The process of diffusion
1
2
Blood cells are too big to pass through the dialysis membrane but body wastes begin to diffuse (pass) into the dialysis solution
3
Diffusion is complete Body wastes have diffused through the membrane and now there are equal amounts of waste in both the blood and the dialysis solution
The process of ultrafiltration in PD 11
22
Blood cells are too big to pass through the semi-permeable membrane but water in the blood is drawn into the dialysis fluid by the glucose
3
Ultrafiltration is complete Water has been drawn through the peritoneum by the glucose in the dialysis fluid by the glucose in the dialysis fluid There is now extra water in the dialysis fluid which need to be changed
Haemodialysis Dialysis process occurs outside the
body in a machineThe dialysis membrane is an artificial
one DialyserThe dialyser removes the excess fluid
and wastes from the blood and returns the filtered blood to the body
Haemodialysis needs to be performed three times a week
Each session lasts 3-6 hrsThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Requirements for HD
Good access to patients circulationGood cardiovascular status (dramatic
changes in BP may occur)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Performing HD
HD may be carried out In a HD UnitAt a Minimal Care Self-Care CentreAt Home
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Unit Specially designed Renal Unit within a
hospital Patients must travel to the Unit 3x a week Patients are unable to move around while on
dialysis may chat read watch TV or eat Nursing staff prepare equipment insert the
needles and supervise the sessions
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
The process of diffusion
1
2
Blood cells are too big to pass through the dialysis membrane but body wastes begin to diffuse (pass) into the dialysis solution
3
Diffusion is complete Body wastes have diffused through the membrane and now there are equal amounts of waste in both the blood and the dialysis solution
The process of ultrafiltration in PD 11
22
Blood cells are too big to pass through the semi-permeable membrane but water in the blood is drawn into the dialysis fluid by the glucose
3
Ultrafiltration is complete Water has been drawn through the peritoneum by the glucose in the dialysis fluid by the glucose in the dialysis fluid There is now extra water in the dialysis fluid which need to be changed
Haemodialysis Dialysis process occurs outside the
body in a machineThe dialysis membrane is an artificial
one DialyserThe dialyser removes the excess fluid
and wastes from the blood and returns the filtered blood to the body
Haemodialysis needs to be performed three times a week
Each session lasts 3-6 hrsThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Requirements for HD
Good access to patients circulationGood cardiovascular status (dramatic
changes in BP may occur)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Performing HD
HD may be carried out In a HD UnitAt a Minimal Care Self-Care CentreAt Home
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Unit Specially designed Renal Unit within a
hospital Patients must travel to the Unit 3x a week Patients are unable to move around while on
dialysis may chat read watch TV or eat Nursing staff prepare equipment insert the
needles and supervise the sessions
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
The process of ultrafiltration in PD 11
22
Blood cells are too big to pass through the semi-permeable membrane but water in the blood is drawn into the dialysis fluid by the glucose
3
Ultrafiltration is complete Water has been drawn through the peritoneum by the glucose in the dialysis fluid by the glucose in the dialysis fluid There is now extra water in the dialysis fluid which need to be changed
Haemodialysis Dialysis process occurs outside the
body in a machineThe dialysis membrane is an artificial
one DialyserThe dialyser removes the excess fluid
and wastes from the blood and returns the filtered blood to the body
Haemodialysis needs to be performed three times a week
Each session lasts 3-6 hrsThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Requirements for HD
Good access to patients circulationGood cardiovascular status (dramatic
changes in BP may occur)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Performing HD
HD may be carried out In a HD UnitAt a Minimal Care Self-Care CentreAt Home
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Unit Specially designed Renal Unit within a
hospital Patients must travel to the Unit 3x a week Patients are unable to move around while on
dialysis may chat read watch TV or eat Nursing staff prepare equipment insert the
needles and supervise the sessions
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Haemodialysis Dialysis process occurs outside the
body in a machineThe dialysis membrane is an artificial
one DialyserThe dialyser removes the excess fluid
and wastes from the blood and returns the filtered blood to the body
Haemodialysis needs to be performed three times a week
Each session lasts 3-6 hrsThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Requirements for HD
Good access to patients circulationGood cardiovascular status (dramatic
changes in BP may occur)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Performing HD
HD may be carried out In a HD UnitAt a Minimal Care Self-Care CentreAt Home
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Unit Specially designed Renal Unit within a
hospital Patients must travel to the Unit 3x a week Patients are unable to move around while on
dialysis may chat read watch TV or eat Nursing staff prepare equipment insert the
needles and supervise the sessions
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Requirements for HD
Good access to patients circulationGood cardiovascular status (dramatic
changes in BP may occur)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Performing HD
HD may be carried out In a HD UnitAt a Minimal Care Self-Care CentreAt Home
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Unit Specially designed Renal Unit within a
hospital Patients must travel to the Unit 3x a week Patients are unable to move around while on
dialysis may chat read watch TV or eat Nursing staff prepare equipment insert the
needles and supervise the sessions
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Performing HD
HD may be carried out In a HD UnitAt a Minimal Care Self-Care CentreAt Home
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Unit Specially designed Renal Unit within a
hospital Patients must travel to the Unit 3x a week Patients are unable to move around while on
dialysis may chat read watch TV or eat Nursing staff prepare equipment insert the
needles and supervise the sessions
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Unit Specially designed Renal Unit within a
hospital Patients must travel to the Unit 3x a week Patients are unable to move around while on
dialysis may chat read watch TV or eat Nursing staff prepare equipment insert the
needles and supervise the sessions
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Minimal Self-Care Dialysis
Patients take a more active rolePatients prepare the dialysis machine
insert the needles adjust pump speeds and machine settings and chart their progress under the supervision of dialysis staff
Patients must travel to the unit 3x weekPatients need to be on a fixed schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Home Haemodialysis
Use of machines set up at home Machines have many safety devices inbuilt Thorough patient training Requires the help of a partner at home every
time Suitability is assessed by the haemodialysis
team Ideal for patients who value their independence
and need to fit in their treatment around a busy schedule
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
HD Access
2 types of access for HD ndash Must provide good flowndash Reliable access
A fistula arterio-venous (AV)Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
AV Fistula Access Matures in about 6 weeks Ensure good working order
ndash Avoid tight clothing or wrist watch on fistula arm
ndash Assess fistula daily notify immediately if not working
ndash Avoid BP cuff on fistula armndash Avoid blood sampling on fistula arm (except daily
HD Rx)ndash Avoid sleeping on fistula armndash Grafts (synthetic) may be used to create an AV
fistula
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Vascular Access Catheter Double lumen plastic tube May be placed in Jugular Subclavian or
Femoral vein May be temporary or permanent Temporary ndash awaiting fistula or maturation Permanent ndash poor vessels for fistula creation
eg children and diabetics Catheters must be kept clean dry and dressed
to prevent infection
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Effects of HD on Lifestyle Flexibility
ndash Difficult to fit in with school work esp if unit is far from home Home HD offers more flexibility
Travel ndash Necessity to book in advance with HD unit of places of travel
Responsibility amp Independencendash Home HD allows the greatest degree of independence
Sexual Activityndash Anxiety of living with renal failure affects relationship with
partner
Sport amp Exercisendash Can exercise and participate in most sports
Body Imagendash Esp with fistula patient can be very self conscious about it
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with HD Rapid changes in BP
ndash fainting vomiting cramps chest pain irritability fatigue temporary loss of vision
Fluid overload ndash esp in between sessions
Fluid restrictionsndash more stringent with HD than PD
Hyperkalaemia ndash esp in between sessions
Loss of independence Problems with access
ndash poor quality blockage etc Infection (vascular access catheters) Pain with needles Bleeding
ndash from the fistula during or after dialysis Infections
ndash during sessions exit site infections blood-borne viruses eg Hepatitis HIV
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Peritoneal Dialysis (PD) Uses natural membrane (peritoneum) for
dialysis Access is by PD catheter a soft plastic tube Catheter and dialysis fluid may be hidden
under clothing Suitability
ndash Excludes patients with prior peritoneal scarring eg peritonitis laparotomy
ndash Excludes patients unable to care for self
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Fluid across the membrane faster than solutes therefore
longer dwell times are needed for solute transfer Protein loss in PD fluid is significant ~ 8-9gday Protein loss uarrs during peritonitis PD patients require adequate daily protein averaging
12 ndash 15gkgday Other substances lost in the dialysate
ndash Amino acids water soluble vitamins some medications and hormones
Calcium and dextrose are absorbed from the dialysate fluid into the circulation
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Addendum to Principles (PD) Standard dialysis solution contains
bull Na+ ndash 132 mEqlbull Cl- ndash 96 -102 mEqlbull Ca2+ ndash 25 ndash 35 mEqlbull Mg2+ ndash 05 -15 mEql
Dialysis solution bufferndash Sodium lactatendash Pure HCo3
-
ndash HCo3- Lactate combinations
Lactate is absorbed and converted to HCo3- by
the liver Dextrose solution strengths 15 25
425The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Types
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated peritoneal Dialysis (APD)
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Dialysis takes place 24hrs a day 7 days a week Patient is not attached to a machine for treatment Exchanges are usually carried out by patient after
training by a CAPD nurse Most patients need 3-5 exchanges a day ie
ndash 4-6 hour intervals (Dwell time) 30 mins per exchange
May use 2-3 litres of fluid in abdomen No needles are used Less dietary and fluid restriction
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CAPD Exchange
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
APD
Uses a home based machine to perform exchanges
Overnight treatment whilst patient sleeps The APD machine controls the timing of
exchanges drains the used solution and fills the peritoneal cavity with new solution
Simple procedure for the patient to perform Requires about 8-10 hrs Machines are portable with in-built safety
features and requires electricity to operate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PD Access
Done under LA or GA
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
DIETWhy is diet important
ndash Managing the diet can slow renal disease
ndash The need for dialysis can be delayed
ndash The diet affects how patients feel
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
CONTROLLING YOUR DIETFoods to control are those
containing
Protein
Potassium
Sodium
Phosphorous
Fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PROTEINS
Animal protein Dairy (milk cheese)
Meat (steak pork) Poultry (chicken turkey) Eggs
Plant protein Vegetables Breads Cereals
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MAJOR SOURCES OF POTASSIUM
MilkPotatoesBananasOrangesDried Fruit
LegumesNutsSalt substituteChocolate
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
SODIUMRegulates blood volume and pressure
Avoid salt
Use Alternate food seasonings lemon and limes spices seafood seasoning Italian seasoning vinegars peppers
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
FLUIDS
Healthy kidneys remove fluids as urine
Check for fluid and sodium retention
Need to restrict fluid intakeThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
PHOSPHOROUS
Phosphorus is a mineral which combines with calcium to keep bones and teeth strong
Too little calcium and too much phosphorus
Need to control the phosphorus in the diet
Need to take a phosphate binder or a calcium supplement
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
VITAMINS
Folic acid
Iron supplements
Do not take OTCrsquos without consulting the doctor
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
MANAGING YOUR DIET
INDICATORS OF GOOD CONTROL
Weight loss or gain
Blood pressure
Swelling of hands and feet
Blood samplesThe Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
LAB MONITORING
Haemoglobin Albumin Calcium Phosphorus GFR (24 hour urine)
Sodium Potassium Urea Creatinine
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD
Flexibilityndash Can be performed almost anywherendash Least impact on work school life (esp APD)
Travelndash Dialysis supplies can be delivered to most parts of
the world travel more flexible APD machines are portable will fit into a car boot can be carried by trainair
Responsibilityndash Requires more responsibility from patient but more
independence
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Lifestyle Changes with PD SportsExercise
ndash Most are possiblendash Advice on swimming lifting contact sports
Sexual Activityndash May affect relations based on patient anxiety
Delivery amp Storage of Suppliesndash Home delivery and storagendash A monthrsquos supplies ndash 40 boxes space to storendash Specially recruited and trained delivery staff
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Monotomy of treatment
ndash The treatment never goes away against days off with HD
Body Image Problemsndash Esp with a permanent catheterndash Abdominal stretching
Fluid Overloadndash Much less a problem than with HD
Dehydrationndash Less common than fluid overload
Abdominal Discomfortndash Bloated feeling
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment Poor drainage
ndash Common problem esp with new patientsndash Fibrin plugndash Catheter displacement
Leakagendash Fluid may leak around catheter exit site (May leak
into scrotum)ndash Stop PD temporarilyndash Resite catheter (use new one)
Infectionsndash Exit site infectionsndash Tunnel infectionndash peritonitis
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Problems with Treatment
Herniandash Aggravation of pre-existing herniae (repair)ndash Evolution of new herniae
Declining effectiveness of the peritoneumndash eg repeated infection
ndash Effect of glucose in the dialysis fluid
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Comparison of Dialysis Treatment OptionsPD Unit HD Home HD
Home Dialysis radic times radic
Convenient Sessions radic times radic
Socializn with other CRF pats times radic times
Home EquipmentSupplies radic times radic
Special dietfluid allowance radic radic radic
Sportsexercises participation Most Most Most
Full day activity -workschool radic Not alwys radic
Direct assistndashpartnerfamily times times radic
Travel radic Delivery of supplies to most destins easy Some notice req
radic Prior arrangements must be made well in advance
times Prior arrangements must be made well in advance
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India We need lots of funds manpower etc to make this vision a reality please contact us Join us as a member for a noble cause
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Our views have increased the mark of the 96000
Thank you viewers Looking forward for franchise
collaboration partners
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-
Contact us- 011-25464531 9818569476
E-mail- nursingnursingyahooin
We are also available on Justdial New Delhi
The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us-